Loading...
HomeMy WebLinkAboutF2022-0576 - Permits��WPOR� City of Newport Beach 4 @ 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 Cqt/cORN�P newportbeachca.gov/inspections Combination Type - Work Class - New F 2 0 2 2 0 5 7 6COMB Permit : F2022-0576 Plan Check No: PC2022 2800` n Issued Date : 11/07/2022 a Inspection Area : FIRE 0 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE D, NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL Job Address: 895 DOVE ST, 475 Description: COMM FIRE ALARM (7) DEVICES Owner: NEWPORT PLAZA OFFICE LLC Address : 2001 ROSS AVE STE2800 DALLAS, TX 75201 Phone : Applicant: ADT COMMERCIAL LLC Address: 210 W BAYWOOD AV ORANGE, CA 92765 Phone : (675) 566-3065 Owner/Builder : Address : Phone Code Edition : 2019 Type of Construction : 1-13 Occupancy Groups: Bldg Height: Building Setbacks Legal Dose : N TR-:7694 BLKfLOT 4 TRACT NO 7694 LOT 4 AND LOT 5 POR OF LOT XC2022-1866 Contractor: ADTCOMMERCIAL LLC Architect Address : 210'W HAYWOOD AV Address ORANGE CA 92765 Phone: (675)566-3065 Phone: Con State Lie : 1065604 State Lie Lie Expire: 05/31/2024°same Bus Lie: BT30072351 Engineer: ° Bus Lie Expire :' 07/31/2023 Address 0 Workers' Compensation Insurance Phone: ° Carrier`: OLD REPUBLIC INSURANCE Policy No: MWC31431721 Designer: ADT COMMERCIALLLdooc W. C. Expire: 10/1/2022''Address: 210 W BAYWOOD AV e 9 e ORANGE, CA 92765 " Phone: (675) 566-3065 ° Fire Sprinklers : YES Construction Valuation : $5,292.56`e Fire Hazard Zone i NO Added/New/TI sq. ft. Bldg : 0 No of Units : 0 e e Alteration sq, ft. Bldg No of Stories s Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 Flood Zone : X Use Zone : PC - Newport Place I �q)Vl FIX PROCESSED BY: 1 I SPECIAL CONDITIONS: e o ease:a e o oat oo e eeoe� e e <, eomeoc e 069(� is License Law does not apply to an owner of property who, through >employees' '.or personal effort, builds or Improves the property, provided that the however, the building or Improvement Issoldwithin one year of completion, the Owner-BUilder will have the burden of proving that it was not built or ued for the purpose of sale). as Owner of the property, am exclusively contracting with licensed Contractors to construct the project (Election 7044, Business and Professions Code; The Contractors' State License Law does not. to an owner of property who builds or improvestthereon, and who contracts: for the projects with a licensed Contractor pursuant to the Contractors' State License Law). tm exempt from Ueensum under the Contractors' Stale License Low for the following reason; I sionature below I acknowladae that: except for my personal residence in which I must have resided for at least one: year poor to completion of the improvements covered by this. permit, I cannot leg ..«..-..... .,,.—,_. _— ___ ......­.. raby affirm under penalty of perjury that l am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division of the Business and Pro lions C8 m ense is In full force effect. License Class License; No Date. Contractor Signat.: -- --.-- IRKERS' COMPENSATION DECLARATION :NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 19 UNLAWFUL„AND SHALL SUBJECT AN. EMPLOYER TO CRVWAIN PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10 000), IN ADDRION TO THE T OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION 3103 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S. FEES. reby affirm urelar pea ltyof perjury one of the following declarations: ) Dgvopnd will,m Umpin a Certificate' of consent to sell -insure for workers'. compensation, Issued by: the Director of IndustrialRelationsas provided for by Section 3700 of the Labor Code, for thi T'c�rmanee of the vm"forwhich this permit Is issued. Policy No. ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued, My workers' compensatior Rant@ carrier: ar"pojioy number are;: my, 0 Policy Number Expiration Date Re df'Agent. �,� Phone-# cadify4hat, roil" performanc of the work for hthis permit is issu I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrar ,,1is ould beco€ae subj=CONSTRUC Insertion provisions of ection 1 f the Labor Coder I shall forthwith comply with those provisions. • •... ._._.:: � Date nature bf Applig$nt TION REG G AGE rebpp a Nm undw penalty 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). 4 r,s area. -• • : Lender's Address ny Signature below, I certify to each of the followiing:: I am the property owner or authorized to act on the property owner's behalf. i have readthis application and the information I have provided Is correct. I agree to comply with all applicable city and co :ordinances an state laws. relating to building construction. S O ROL)S (-I _ Fl H 12 4 /L- I authorize representatives of this city or COUP to enterthe a v%idenlfNe property for Inspection purposes. 9ature of Prop eft Owner or Authorized / a.. -- Pint Property Owners or Authorized Agent's Name ate riON I DATE I By I DECLAR orgoF COMA IANCE WITH. Cox Or FEDERAL FOR OFFICE USE ONLY NOTAPPLt4ABt£ TO