HomeMy WebLinkAboutX2022-1451 - Permitso��tiwPoR� City o'f NDewport BPament- Building Division II III I III II I III I IIIII I II COMB Permit : X2O22-1451
n100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: 1330-2022
Z Permit Counter Phone: (949) 644-3288 Issued Date : 08/09/2022
cy �`• �P Inspection Requests Phone: (949) 644-3255 Inspection Area : 7
4 conN newportbeachca.gov/inspections
Combination Type - ELEC
Work Class - Other
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 : 330 PLACENTIA AVE
Description: COMM -INSTALL 1 DUAL -PORT ELECTRICAL
Owner: THE HOAG MEMORIAL HOSPITAL I
PRESBYTERIAN
Address : 500 SUPERIOR AVE STE200 NEWPORT
BEACH, CA 92663
Phone:
Applicant:
VIDEO VOICE DATA COMMUNICA
Address :
12681 PALA DRIVE GARDEN
92841
Phone:
(714)897-6300
Owner/Builder
Address
Phone :
Code Edition : 2019
Type of Construction :
Occupancy Groups: U
Bldg Height:
Building Setbacks :
Flood Zone : X
Use Zone : OM - Office --Medical
PROCESSED BY:
SPECIAL CONDITIONS:
Esc : N TR 4692 BLK LOT 100
E CHARGING STATION
or: VIDEO VOICE DATA COMMUNICATIONS Architect:
12681 PALA DRIVE GARDEN GROVE, Address
CA 92841
(714) 897-6300 Phone
e Lic : 821598 State Lic
,e : 07/31 /2023
AVE, CA Bus Lic: BT30048732 Engineer:
Bus Lic Expire : 1013112022 Address
Workers' Compensation Insurance Phone:
Carrier: ; OLD+REPUBLIC+GENERAL+INSURANCE+C
ORPORATION
Policy No: AlCW12781804.. Designer: VIDEO VOICE DATA COMMUNICATIONS
W. C. Expire: 1Ill 4/2022 Address: 12681 PALA DRIVE GARDEN GROVE, CA
92841
Phone: (714) 897-6300
Fire Sprinklers : NO
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
$25,000.00
0
o
I hereby affirm under penalty of perjury that $ am exempt horn the Contractors'State License Law foi
ction 7031.5, Business and Professions. Code: Any city or countythat requires a permit to construct,
I have placed next to theapplicable items)
ar to Its issuance, also requires the applicant for
i Section 7000) of Division $of the Business and
permit subjects: the applioant to a civil penalty of.
nore than five hundred dollars ($500);
1, as owner of the property, or my employees with wages as th T sole compensation, will do (_) all of or (_) portions -of the work';: and the structure Is not intended proffered for sale (Section 7044,:
mess and ProfEssions Code: The Contractors' State License Law does not apply to anowner of property who, through employees' or personal effort, builds or improves the property, provided that the
ovements 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
oved for the purpose of sale)...
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.
y 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),
t am exempt from licensure under the ContractorsState License Law for the foltowing reason:
ay signatures: below I acknowledge that, exceptfor my personal residence in which I must have resided for at least oneyear prior to completion of the improvementscovered by this permit, I.cannot lec
of
by affirm under penalty of perjury that 1 am licensed under provisions of Chapter $-(commencing with SecGo 70 O) of D' sip '3.of the Business and Profs si s and v: license.i's infiulf fgcCe
iffect. License Class License No Dot l� Contractor Signatures
tKERS' COMPENSATION DECLARATION i
NG: FAILURE TO SECURE WORKERS` COMPENSATION COVERAGE IS UNLAWFUL, ANDSHALL. SUaJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES VP TOONEHUNDRED T SAND DOLLARS : 00). IN ADDITION TO THE
OF COMPENSATION; DAMAGES AS PROVIDED FOR W SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES
by affirm under penalty of perjury one of the following. declarations:
have and wif maintain a certificate of consent to self -insure for workers' compensation, issued by: the Director of Industrial Relationsas provided for by Section 3700 of -the Labor Code, for th
maance of the work for which this permit is issued. PolfcyNo.
ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Coda, for the performance of the work for which this: permit is issued. My workers' compensatioi
arise carrier and policy number are:.... _
ir. Policy: Number Expiration Date
no of Agent.. Phone tf
certify that, in the perform nce 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
I. if I should become ubj. t t0 "hikers' compen ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature ofApplicant �� Da%P _.C(
CLARATIQN R£GAR G TRUCTIDN L£ GE.NCY
ireby affirm under panel
fyof perjury that there is nstructipnlending agency for the performance of the Work: for which this. permit. is issued (Section 3097. Civil Code):.
iders Name.. Lender's Address
my signature below, I certify to each of the followingt.
I am the property owner or authorized to act on theproperty owner's behalf.
I have read this application and the information I helve provided is correct
1 agree to comply with all applicable City afld GUI y ordinances and slate laws relating to building construction. )
I authorize representatives of this city orrpun enter})e abDve-rdentifiedprop in pectlon purposes. ,
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FOR OFFICE USE
All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shalt
be in place priorto approval to fill pool/spa -&:shall remain in place & be maintained for the
life of the pool,