HomeMy WebLinkAboutF2023-0102 - Permits�EwaoRT City of Newport Beach II �������������I����I�I���I�I� II
p Community Development Department- Building Division F 2 0 2 3 0 1 0 2 COMB Permit: FZOZ3-O IOZ
a �N 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-0443
Permit Counter Phone: (949) 718-1888
3/2023
newportbeachca.gov/civic Issued Date :
Inspection Area ea : : FIRE
Cq<IF00.H�P Combination Type - MFP
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: 2500 BAYPOINTE DR Legal Desc : N TR 14989 BILK LOT 1 TR NO 14989 FOR OF LOTS 1 & 2
Description: FIRE ALARM SYSTEM PANEL REPLACEMENT FOR 23 BUILDINGS AND LEASING OFFICE
Owner: IRVINE CO
Address : 111 INNOVATION
IRVINE, CA 92618
Phone : (949) 608-9659
Applicant: INTERFACE SYSTEMS
Address : 3750 SCHAUFELE AV, 200
LONG BEACH, CA 90808
Phone: (562)353-4680
Owner/Builder :
Address :
Phone
Contractor: INTERFACE SYSTEMS
Address : 3750 SCHAUFELE AV, 200
LONG BEACH, CA 90808
Phone:
(562)353-4680
Con State Lic
: 469046
Lic Expire :
08/31/2023
Bus Lic :
BT30046473
Bus Lic Expire : 03/31/2024
Workers' Compensation Insurance
Carrier: TRAVELERS PROPERTY CASUALTY CO OF
AMERICA
Policy No: UBOK0634482243G
W. C. Expire : 10/1/2023
Code Edition : 2022
Fire Sprinklers : YES
Type of Construction :
Fire Hazard Zone : NO
Occupancy Groups :
No of Units : 0
Bldg Height:
No of Stories :
Building Setbacks:
Flood Zone : X
Use Zone: PC - North Ford
PROCESSED BY:
SPECIAL CONDITIONS:
Architect
Address
Phone:
State Lic
Engineer
Address
Phone : -ub
Designer: INTERFACE SYSTEMS
Address : 3750 SCHAUFELE AV, 200
LONG BEACH, CA 90808
Phone: (562)353-4680
Construction Valuation : $138,000.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
�"'1 CP(�
Dv
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(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
ie 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
'rofessions Code) or that he or she is exempt from licensure 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure Is not intended or offered for sale (Section 7044,
lusiness 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 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
poly 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).
I am exempt from licensure under the Contractors' Slate 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 Camef legally
all 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://www.leginfo.co.govlcalow.htmi.
lignalure 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
FANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN BECTON 37M OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES.
hereby affirm under penalty 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 of the Labor Code, for IN
erformance Of the work for which this permit Is issued. Policy No.
have 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'
rance carrier and policy number are:
Policy Number
of Agent
Date
certify that, in the performance 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
if I should become subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant __ _,,,_,___ Date_-_
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby affirm under 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).
enders Name Lender's Address
y my signature below. I certify to each of the following:
I am the properly owner or authorized to act on the property owners 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 stale laws relating to building construction,
I authorize representatives of this city or county to enter the above -identified property for inspection purposes.
iq nature of Propertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name _ Date
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITCANCELL£D
PERMIT EXTENDED
PERMITFINAL ( YLn/I� 30/a� AAULJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF Ir// PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE: