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HomeMy WebLinkAboutF2023-0057 - Permits4 ,EWPo City of Newport Beach p @ Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 u ? Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 C9CirppN�P newportbeachca.gov/inspections Combination Type - Work Class - Other F 2 0 2 3 0 0 5 7� COMB Permit : F2O23-005% Plan Check No: PC2023-0230 Issued Date: 02101/2023 Inspection Area :A, r I 1 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: 215 15TH ST Legal Desc : T6S R10W SEC"33 POR OF SE1/4 NE1/4 AND POR OF ADJ ABAND ALY AND TR NO 234 B LK 115 Description: COMM HOOD SUPPRESSION SYSTEM Owner: STATE OF CALIFORNIA Address : 100 HOWE AVE #100-SO SACRAMENTO, CA 95825 Phone: Applicant: HEDRICK FIRE PROTECTION Address : 13309 CENTRAL AVE CHINO, CA 91710 Phone : (909) 613-0083 Owner/Builder: Address : Phone Code Edition : 2022 Type of Construction Occupancy Groups: Bldg Height: Building Setbacks Flood Zone : AE, 8 FT; X Use Zone: PC - Marina Park PROCESSED BY: -- SPECIAL CONDITIONS: No Phone: State Lic �3 Engineer Address Phone OMPA Designer: HEDRICK FIRE PROTECTION Address : 13309 CENTRAL AVE ,fir CHINO, CA 91710 Phone : (909) 613-0083 .... a N.O.• Construction Valuation $4,090.•00% p ° a°°°°; Added/New/Ti sq. ft. Bldg : 0 Alteration sq. ft. Bldg : a Added/New sq. ft. Garage: 0 ...... TOTAL sq. ft. 0 .... a vo ° ° • OO°iR �J OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License (Section 7031.5, Business and Professions Code: Any city: or county that requires a: permit to cone © 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered.for sale (Section 7044, Business and Professions Coda: The Contractors State. License Law does not apply to an owner of property who, through ernpfoyees or personal effort, builds or improves the property, provided that the improvements are not intended or offered for: sale. If, however, the building or improvement issoldwithin oneyear of completion, the Owner -Sunder will have the burden of proving that it was not built: or Improved for the purpose of sale), I. r, 1, as owner ofthe property,: am Exolusivety.contracting-with licensed Contractors to construct the project(Section 70", Business and Professions Coda: The Contractors' State License Law does Wt apply to an owner ofproperty who builds or improves,thereon, and who contracts for: the projects with a licensed Contractor pursuant to the Contractors' State License Law). © 1 am exempt from ilcansure under the Contractors' State License Law for the following reason. i 8: (Commencing with and effect. License Class License No Da Z' <- c:ontractorblgnatu€r i WORKERS'COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WGRKERW COMPENSATION COVERAGE Ia UNaAWFU[.. AND SHALL SUBJECT AN. EMPLOYER TO CR INAL PENALTIES AND CALL, FINES UP To ONE HUNDRE THOUSAND DOLLARS f$100,0001<IN ADDntoN To rKr COST OF COMPENSAmoN. DAMAGES As PROVIDED FOR IN SECTION 3706 Of THE LABOR CODE, INTEREST, AND ATTORNEY's FEES: I hereby affirm rtnder penalty of perjury one of the following declarations, t have and will maintain a certificate of consent to self -insure for workers'. compensation, issued by: the Director of industrial :Relations as provided for by Section 37000 of the.. Labor Code; for ON zelormance of the work for which this permit is issued, Policy No, and will maintainwodters' compensation insurance, as rac{uired by Section 3700 of: the Labor Code, for the performanco of the work for which this permit is issued. My workers' compensakio and insu a carrier -and policy number are: _ Carrier Policy Number Expiration Date Name of Agent Phone #.. i certify that„ ins the ps ormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the work ':Cattpensation laws of Califomia, and agre that, if I should bec ,rt a Object: the era'.. Coro lion provisions, of Section 3700 of the Labor Code, I shall forthwith camply with those provisio_ its • Y +y g rY n9 agency pa Da„ — i SignatureApp --- iDheereb lfrmnundest I Q u that here s aN construction lending a enc for performance of the work forwhich this permit is. issued (Section 3 7, Ivil Code): e. er's Address ♦ I'agre l to DOX wiih.ail applicable city ant • I autkorize represenNives-of this city of cot iaib"e of Proow;b QwPer or Authorized Age$ AC'fiTShL• DATE. BY PC41f.?i3E7f�fflEfl • PFMM'!f�iNCECCEA TO 7