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HomeMy WebLinkAboutXC2022-1991 - PermitsCity of Newport Beach Community Development Department- Building Division F� 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 - wax Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/Inspections Combination Type - Work Class - Other IIII I I II I I III I COMB Permit : XC2O22-1991 Plan Check No: i95o -- ( cl, Issued Date : 1010512022 Inspection Area : -7 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 : 850 SAN CLEMENTE DR Legal Desc : Description: DEF SUBMITTAL EMERGENCY 250KW GENERATOR Owner: VIVANTE NEWPORT CENTER LLC Address : 1 MACARTHUR PL STE300 SANTA ANA, CA 92707 Phone Applicant: NADEEM MOHAMMED Address : 1 MACARTHUR PL SANTA ANA, CA 92707 Phone: (562)900-5958 Owner/Builder Address : Contractor: NEXUS CONSTRUCTION SERVICES INC Address : 1 MACARTHUR PLACE SUITE 300 SANTA ANA, CA 92707 Phone: (714)546-5600 Con State Lic : 767678 Lic Expire : 08/31/2023 Bus Lic: BT30071422 Bus Lic Expire : 03/31/2023 Workers' Compensation Insurance Carrier: OAK RIVER INSURANCE COMPANY Policy No: NEWC315020 W. C. Expire: 7/1/2023 Architect: HARRIER DONALD Address: 1030 TEHAMA AVE MENLO PARK CA 94025, CA 94025 Phone: (415)356-3800 State Lic : Engineer: VANDERVISJACOB Address : 701 N PARKCENTER DR SANTA ANA CA, CA Phone: (714)560-8200 Designer: Address Phone: Phone Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $0.00 Type of Construction : Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg Bldg Height : No of Stories : Added/New sq. ft. Garage : 0 TOTAL sq, ft. Bldg : 0 Building Setbacks Flood Zone Use Zone: PROCESSED BY SPECIAL CONDITIONS I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reasonts) indicated below by the checkmark(s) I have placed next to the applicable Lenr ) (Section 7031.5. Business and Professions Code: Any city or county that requires a. peril to construct, alter. improve. demolish, or repair any structure, prior to Its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant. to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensum and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U pohions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property Who, through employees' or personal effort, builds or improves the property, provided that the improvements are not Intended or offered for sale. IL however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). © 1, as Owner of the property, am exclusively contracting with licensed Contractors to construct his project (Section 7044, Business and Professions Code: The Contractors' State License Law dues not ar�iply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors Stale License Law) U I am exempt from Imensure Under the Contractors' Slate License Law for the following reason By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year priorto completion of the improvements covered by this permit, I cannot -is sell a structure that I have burnt as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following tNeb ske:http:l:w,nv.leginfo.ca.govlcalaw.html. Signature of Property Owner or Authorized Agent Date _ LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 Di - n 3 of the Business and Profession ^ B, an m se is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100, D01, IN ADDRION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. II hereby affirm under penalty of perjuryone of the following declarations: 171 1 have and will maintain a cor ificale of consent to self -insure for workers' Compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for lh performance of the work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers rance carrier and policy number are: of Agent certify that, in the performance of the work for if I should become subject to iherw4r4ers' cry of Applicant Policy Number Expiration Date this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre soon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. __„_.,_....,.,,........._....,....,,_„.._._._.____......._._..._____......._..__..__.._.__.__..._.._._.____.�._______�.v______ Date It� Mr. er.I=Mew �.N....__....................._... hereby affirm under penalty of perjury that there is a konstructfon lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code). ender 5 Name Lender's Address y my signatura balr+, I. certify to each of the following. I'em the property owner or authorized to act on the properly owner's behalf. I'have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and slate laws relating to building construction I authorize representatives of this city or county to ant/apt abov led property for inspection purposes. 1 h» e� / ,,�,c.� icnanlre of Pi lv Owner or Authorized Anent \ Print Property Owner's or Authorized Agent's Name I�rnY f it I oil /+CTION DATE BY j DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL i RFGULATIONS PART 61 OFTITLE40ANDAONtD RULE 1403 FOR OFFICE USE ONLY _ v ll I fXP HF. fJ 1 SUBMITTED A58F.STOS NOTIFICATION TO PEPW TCANrc1 LFI P ^i I cRir JJEO 0CPA . _ �A ..... _ .—__ _. AOMD PrRV'i FINAI. _ _. LNII SRESTOS NOTIFICATION IS NOtJ APPLICABLE TO ENiOKZ Q//I OCCUPANCY ISSUED SI NATUREI