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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. , 'ilY'iY'i• • •• P£RhMFEXPtRED �PRM1FCklYCEILE _� _T.�.. RERIv"EXf6NdE0 pM7!i?VNAl. •. CPR5IF'f,47EOF 9E@:,A,'KNCy fssufti s •e ecooeo cc c 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,