HomeMy WebLinkAboutXC2022-2034 - Permits�EWPORT City of Newport Beach
Community Development Department Division COMB Permit : XC2022-2034
p a Y P P 9 X C 2 e 2 2 2 6 3 4
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2022-2670
u S Permit Counter Phone: (949) 644-3288
yam+ Issued Date
� Inspection Requests Phone: (949) 644-3255
CgGiFpµN�P newportbeachca.gov/inspections Inspection Area : 7
Combination Type - ELEC MECH PLUM
Work Class - Tenant Improvement
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 510 SUPERIOR AVE Legal. Desc : A TR:.IRVINE SUB BILK 2 LOT 'i169:IRVINE SUB LOT 169 BLK 2 PORS OF LOT
Description: COMM - TI INSTALL PET/CT IMAGING UNIT FOR HOAG RADIOLOGY
Owner:
Address
Phone
BILL QUIRAM Contractor: GUTHRIE'GENERAL .OF.CAINC Architect: LIEBKE STEVEN S
1 HOAG DR
NEWPORT BEACH, CA
Applicant:
GUTHRIE GENERAL OF CA INC
Address:
6677 WEST THUNDERBIRD STE C
GLENDALE, AZ 85306, CA
Phone:
(602)390-2705
Owner/Builder
:
Address :
Phone
Code Edition :
Type of Construction
Occupancy Groups:
Bldg Height :
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY:
Yj-16
X l_
OM - Office --Medical
I2
SPECIAL CONDITIONS:
Address': 6677'WEST ':THUNDERBIRD .STEC::
Address :
GLENDALE, AZ 85306, CA'.
Phone:: (602):390-2705
Phone:
Con State Lie : 951506
State Lie
Lie Expire: 0813112024
Bus Lich BT30071412
Engineer:
Bus Lie Expire :'03131/2023 ..Address
Workers' Compensation Insurance
Phone
Carrier:; AMERISURE 'MUTUAL INSURANCE
.` COMPANY
Policy No: WC2103602
Designer
W. C. Expire: 10/1/2023
Address
Phone:
1340 REYNOLDS AVE #115IRVINE, CA
92614
(949)400-5462
STEPHEN ZAJICEK
150 PAULARINO AVE•Al2/d ' s • oa e
COSTA MESA, CA 92$26'"'
(949)852-9995 . .'
- Fire Sprinklers : YES
Construction Valuation :
Fire Hazard Zone.:. NO
- Added/New/TI sq. ft. Bldg
No of Units : 0
Alteration sq. ft. Bldg :
No of Stories : -
Added/New sq. ft. Garage
TOTAL sq. ft.
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OWNER -BUILDER DECLARATION
t hereby affirm :under penalty of peoury:that f am exempt from
ction 7031A Business and Professions Code: Any city: or cot
permit to file asigned statement that heor she is licensed pu
fessions Code) or that he or she is exempt from licensors anc
more than five hundred dollars (WO).
I, as owner of the property, or my employees with wages as t
roved: for the purpose of sale).
it sole compensation, will do U all
w does not apply to an owner of in
building or Improvement is sold wit
I, as owner of the property,am exclusively: contractingwith licensed Contractors to construct the project (Section 7044,
lyto an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor
I am exempt from licensors Under the Contractors' State License Law for the following reason:
ny signature below I acknowledge that; except for my personal residence in which I must have resided for at least one q
a structure that I have built as an owrier-builder if it has not been constructed in its ontirety by licensed contractors. I'un
fessions Code,. is available upon request when this application is submitted orat the following Web site:hitp:/hvww.Iegin
under provisions of Chapter 9 (commencing with Section
License No Daft
COMPENSATION DECLARATION
hereby affirm unde4 penalty of perjury one Of the following declarations:
3....4
I have and will♦maintain acertiiidate of consent to sell -insure for wark¢r3' compensation, Issued by the pirectarof
6rti ntaace of the work fqr which this permit is issued. Policy No,
....
!I h 'and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor , for the po
is `nce carrier and.pollcy number are:
:airier • . •. Policy Number
Iaoieuf Agent • • `
lwrbfy that, in-thlh po ffprmance of the work for which this permit is issued. (shall :not employ any person in any manner I
tal,;,l sji4uld becrAnClubjeeA-"tbe workoT,s E)rnpensation provisions of Section 3700 of the Labor Code, I shall forthwith
is
. ..
I am the property owner or authorized to act on.
1 have read this: applicationand the information
1 agree to comply with all Applicable city and Do
I authorize representativesofthis city or county
PERMIT r4IVCELLED
PERYIITFKtEMDED
PERMIT FINAL
ISSUED
agency for the performance of the work for
behalf.
?rect.
state laws relating to building construction.
lenlified property for Inspection purposes.
NOT119CATIONJS NOT APPUCAatE TO
MOUTON
I have :placed next to the applicableitem(s)
)r to its issuance, also requires the applicant for
i Section 7000) of Division 3 of the Business and
permit :subjaotsthe:applicant to a..civil penalty of
not intended or offered for sale (Section 7044,
builds or improves the property, provided that the
have the burden of proving that it: was not builtor
and: Professions :Code: The Contractors State License. Law. does not
to the Contractors' State License Law),
the: applicable
the Business and Professio e,: and y conic is In full force
tra:
Conctor Signature r,� /> a,., �r-:.c
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (ST00,000), IN AUDITION TO THE
as provided for by Section 3700 of the Labor Code, for
for which this .permit is issued. My workers`
Date
become subjectto the workers` compensakion laws ofCai forria, and agree
with those provisions.
Date X ///-V kz _.
mitis issued (Section 3097, Civil Code).