HomeMy WebLinkAboutF2022-0391 - Permitse; City
o'f NDewport Beamient-Building Division IIII I I III II I Il llfl III I II COMB Permit : F2022-0391
_` nF 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2022-1875
.F�. Ta Permit Counter Phone: (949) 644-3288 Issued Date : 07/28/2022
<< r Inspection Requests Phone: (949) 644-3255 Inspection Area : it �fi
"'9y conN` newportbeachca.gov/inspections °L
Combination Type -
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 : 5190 CAMPUS DR Legal Desc : P BK 142 PG 18 PAR 2
Description: COMM (HOAG HOSPITAL) REPLACE FIRE SPRINKLER MONITORING SYSTEM (9) DEVICES
Owner:
CMM HOLDINGS I LLC
Contractor: COSCO FIRE PROTECTION INC
Address :
1800 QUAIL ST STE110 NEWPORT BEACH,
Address: 1075 LAMBERT RD, BLDG D BREA, CA
CA 92660
92821
Phone:
Phone: (714)974-8770
Con State Lic : 577621
Applicant:
COSCO FIRE PROTECTION INC
Lic Expire: 09/30/2023
Address :
1075 LAMBERT RD, BLDG D BREA, CA 92821
Bus Lic: BT00022773
Phone:
(714) 974-8770
Bus Lic Expire: 07/31/2022
Workers' Compensation Insurance
Owner/Builder:
Carrier: ACE+AMERICAN+INSURANCE+COMPANY
Address :
Policy No: WLRC68917396
Phone:
W. C. Expire : 1/1/2023
Code Edition : 2019
Fire Sprinklers :
Type of Construction :
Fire Hazard Zone
Occupancy Groups:
No of Units :
Bldg Height:
No of Stories
Building Setbacks :
Flood Zone: X
Use Zone: PC - Koll Center
PROCESSED BY:
SPECIAL CONDITIONS:
Architect
Address
Phone:
State Lic:
Engineer:
Address
Phone :
Designer:
Address :
Phone:
NO Construction Valuation :
Y Added/New/Ti sq. ft. Bldg
9 Alteration sq. ft. Bldg
1 Added/New sq. ft. Garage
INSPECTOR
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$3&489.00
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I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the cbeckmark(s) I have placed next to the applicable item(s)
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
he 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
Yofessions Code) or that he or she is exempt from licensure 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
of more than five hundred dollars ($500).
11, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iusiness 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
nprovements are not intended or offered for sale. If, 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
nproved for the purpose of sale).
1 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I I am exempt from licensure under the Contractors' State License Law for the following reason:
ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to Completion of the improvements Covered by this permit, I cannot legally
ell a structure that I have built 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
Tofessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfb.ca.gov/calaw.htmi.
lignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affinn under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectiop)000 f Div' ion 3 of the Business and Pro o Co nd r license is in fu_ II force
end effect. License Class License No Contractor Signatur
VORKERS' COMPENSATION DECLARATION
EARNING: 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 4100,000), IN ADDITION TO THE
OST OF COMPENSATNON,.DAMAGES AS PROVIDED FOR IN SECTION 37M OF THE LABOR CODE, INTEREST, AND ATTORNErS FEES.
hereby affirm underpenalty of perjury one of the following declarations:
e'•MN • and 4411 JASiRtain a certificate 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 thi
Vance of the work for which this permit is issued. Policy No,
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' compensatior
1surance Carrier.dhdA:cy number are:
:frier • •' ' Policy Number Expiration Date
lame III Agent •• —Phone #
3wr4that, in the performance of the work for which 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,
rat Wl SUould become subje�cbto the wor We sation provisions of Section 3700 of the Labor Code, I shall forthwith Comply with those provisions.
lignalureofAppRcapP�)) [ /—/l!'+� Da �
IB6FARRTION RF�GA QING CONSTRUCT. LENDING AGENCY
Ne6sitiV.6f irm under perreity of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
antler's Name • • • Lenders Address
ly my signature below. I certify to each of the following:
I am the property owner or authorized to act on the property 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 ordi ances and state la relating to building construction.
I authorize representatives of this cityor county to erahove f8�nt' property for inspection purposes.
ACTION I DATE BY DECLARTION OF I REGULATIONS PARTDMPLIANCE WITH CODE OF 61 OF TITLE 40 AND AQMD RULE AL I FOR OFFICE USE ONLY
PERMIT EXPIRED
PERMITCANCELLED
PERMITEXTENDED
PERMIT FINAL
CERTIFICATE OF
DCCUPANCYISSUED
EP—® A
All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
DAQMD
be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the
r-
1_I ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
Ine of the pool.
PROPOSED DEMOLITION
SIGNATURE: