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Home My WebLink AboutF2022-0503 - Permitse��WPoRr City of Newport Beach Community Development Department- Building Division �. -' 100 Civic Center Drive, Newport Beach, CA 92660 --- S Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 °g4FoaN�P. newportbeachca.gov7nspections Combination Type - Work Class - Tenant Improvement II II I I II I I I II IIII IIII II COMB Permit : F2022-0503 Plan Issued eheck No : PC2022-2412 Inspection Area : FIRE 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 : 11 HOAG_DRLegal esc : ATRTRVfNE SUB BLrtiTLOT17697RVINE-SU=K7LOTS-169-&-17-0- POR-OF LOTS&-BLK Description: COMM FIRE ALARM SYSTEM B DEVICES (X2021-2023) Owner: HOAG MEMORIAL HOSPITAL-PRESBYTERIAN Contractor: TRL SYSTEMS INCORPORATED Architect Address : Address : 9531 MILLIKEN AVE Address : r p NEWPORT BEACH, CA 92658 RANCHO CUCAMONGA, CA 91730 W, Phone : Phone : (909) 390-8392 Phone Con State Lie : 413747 State Lie Lie Expire : 11/30/2023 Applicant: TRL SYSTEMS INCORPORATED Bus Lie: BT02071605 Engineer Address : 9531 MILLIKEN AVE Bus Lie Expire : 06/30/2023 Address RANCHO CUCAMONGA, CA 91730 Phone: (909) 390-8392 Workers' Compensation Insurance Phone: Carrier : HARTFORD Owner/Builder : Policy No : 72WEZR5673 Designer: TRL SYSTEMS INCORPORATED Address : W. C. Expire : 10/112023 Address: 9531 MILLIKEN AVE RANCHO CUCAMONGA, CA 91730 Phone: Phone: (909) 390-8392 Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : $24,655.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : A3/B No of Units : 0 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft. Bldg: 0 Building Setbacks Flood Zone : X Use Zone : PC - Hoag Hospital PROCESSED BY: 0 SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable ftem(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 io permit to file a signed statement that he or she is licensed pursuant to the previsions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofossions Code) or that he or she is exempt from lieensure 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do(_) all of or (_) portions of the work, and the structure is nol intended or offered for sale (Section 7044, 'usiness 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, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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). 3 I am exempt from lieensure under the Contractors' State License Law for the following reason: —._ -------------- _._ ry my signature below I acknowledge that, except for my personal residence in which I must have resided forat least one year prior to completion of the improvements covered by this permit, I cannot legalll oil 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:l/w Nv.leginfo.ca.gov/calaw.html, signature or Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectiog7lgof DIV lion 3 of the Business and Prf♦((a ons rE y Ilcense is In full farce nd effect. License Class License No DaO f0 Contractor Signal1 WORKERS' COMPENSATION DECLARATION ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS t6700,000J, IN AUDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION OTUfi OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm underpenaliy, of perjury one of the following declarations: I 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 3700 or the Labor Code, for th r)rformance 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' carrier and policy number are: Policy Number Expiration Date me of Agent Phone M certify that, in the - - ormanoe of th work for which this permit is issued. I shall not. employ any person in any manner so as to become subject t0 the workers' compensation laws of California, And ogre I. if I should becom ubje A to th rkers' compensationvisions of Section 37UO of the Labor Code, I shall forthwith comply with those provisions. IP PY P / nature of APPiican _ CLARATION REG RDING NSTRUCTION LE G AGENCY areby affirm under enalty of perjury that there Is a fo traction lending agency for the performance of the work for which this permit is issued (Section 3097 IA Code). orders Name _ Lender's Address 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 comity ordinances and state laws relating to building construction. I authorize representatives of this city or co lynto mer t bove-identified property for inspection purposes. nature of Property Owner or Authorized Agerfi Print Property Owner's or Authorized Agent's Name GJ�f , j� 0�°5 O e GD/f 0!1�" ACTION I DATE E By ECLARATION OF CO PL xNCE WITH CODE OF FEDERAL I ' R, TIONS PART 61 OF TITLE AO AND AONID RULE j 1403 FOR OFFICE USE ONLY PERMITEXPIRED f ISUBMITPEDAS3FFTOSN0(FIC TION TO PERMIT CANCftLEO IIEPA ..RM.___ PEIT EMENDEDa rr--11 I I OMD PC-PoY9IT FiNAL...._...... ..To� USj.ry 1`0_._ rJ ASBESTOS NOfl FICAtION i5 NUl' APPLICABLE TO CERTIEIC47E OF 1 PROP05ED DEMOLITION OCCUPANCYISSUEO I SIGNATURE:.