HomeMy WebLinkAboutF2023-0107 - PermitsCity of Newport Beach
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Community Development Department- Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
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newpormeachca.gov/inspections
Combination Type -
Work Class - Tenant Improvement
����������� 11COMB Permit : F2023-0107
Plan Check No: PC2023-0462
Issued Date : 03/02/2023
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 : 1301 DOVE ST, 130 Legal Desc : P BK 120 PG 27 PAR 1
Description : COMM FIRE ALARM TI - 5 DEVICES (X2022-2107)
Owner: OCEAN WEST, WEST CAPITOL PARTNERS
Address: 2101 ROSECRANS AVE STE3270
EL SEGUNDO, CA 90245
Phone :
(213) 326-4539
Applicant:
H C I SYSTEMS INC
Address :
1354 S PARKSIDE PL
ONTARIO, CA 91761
Phone:
(909)628-7773
Owner/Builder :
Address :
Phone
Contractor: H C I SYSTEMS INC
Address : 1354 S PARKSIDE PL
ONTARIO, CA 91761
Phone: (909)628-7773
Con State Lic :
905493
Lic Expire :
02/29/2024
Bus Lic:
BT30042287
Bus Lic Expire
: 02/29/2024
Workers' Compensation Insurance
Carrier: FEDERAL INSURANCE COMPANY
Policy No: 54309498
W. C. Expire : 3/2/2023
Architect
Address
Phone:
State Lic
Engineer:
Address
Phone
Designer:
GARY RAMIREZ
Address :
1354 S PARKSIDE PL
ONTARIO, CA 91761
Phone:
(909)957-5200
Code Edition :
2022
Fire Sprinklers ;
YES
Construction Valuation :
$2,340.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
No of Units :
0
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories :
10
Added/New sq. ft. Garage:
0
TOTAL sq. ft.:
0
Building Setbacks
Flood Zone :
X
Use Zone :
PC - Newport Place
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SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State, License Lawlor the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
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
in permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Yofassions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a Civil penalty of
of more than five hundred dollars ($500).
3 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
tusiness 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 builtor
nproved for thepurpose of sale).
3 1, 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 net
ppiy to an owner of property who builds or Improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
3 1 am exempt from Iicensure under the Contractors' State License Law for the following reason:
ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements Covered by this permit I cannot legally
all a structure that I have built as an owner-buildor if it has not been Constructed in its entirety by licensed contractors. I undorstand 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:liwww.leginfo.ca.govlcalaw.htmi.
.ignature of Property Owner or Authorized Agent _ .� Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) vrsi� - of the Business and Professionstd�/and Dwii¢ense is In full force
re
nd effect. License Class License No D QG Contractor Signatu
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,0001 IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYe FEES,
hereby affirm underpenaltyof perjuryone of the following declarations:
I I have and will maintain a Certificate of consent to sell -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
arformancs of the work for which this permit is issued. Policy No.
have and will maintain workers' compensation insurance, a$ required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
Fence carrr_erAnd policy number are:_ „
Number
Date
me of Agent / Phome #
I certify that, in the performance of the work for which this permitis issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agru
t, if I should become subjeecctt to the workers 'Pop e�nsaboonn7provisions of Section 3700 of the Labor Code, I shall forthwith Comply with those provisions.
nature of Applicant lf.yte
CLARATION REGARDIN14 60INVRUCTION LENDING AGENCY
3reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for whichthispermit is issued (Section 3097, Civil Code).
)does 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 county ordinances and slate laws relating to building construction.
I authorize representatives of this city or count` to the above-i Hiffed property for inspection purposes. t� /j - //fit w.�J
nature of Prooertv Owner or Autnorzed AaemN Print Proeertv Owner's or Authorized Aaent's Nalxte/I \' l IVIa W 0/ 0I ' o Date
ACTION
DATE.
j BY \ j DECLARATION OF COMPLIANCE W17H CODE Of FEDERAL
I REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
FOR OFFICE USE ONLY V \
PERMITEXPIRED
i I SuR.AITTErIASBESTOS NOT F CATION TO
PERMIT CANCELLER
11EFA
PERMIT FXTfNpfp
PERMITFINAL
Ia.. Q [AD
v/ ASBESTOS NOTiFICAI ION IS NOT APPLICABLE TO
CERTIFICATE Of
( PROPOSED DEMOLITION
OCCUPANCY ISSUED
# SIGNATURE: