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Home My WebLink AboutF2023-0172 - Permitse�EWPoar City of Newport Beach Community Development Department - Building Division F 100 Civic Center Drive, Newport Beach, CA 92660 6 ? Permit Counter Phone: (949) 644-3288 a.� Inspection Requests Phone: (949) 644-3255 c94FppN�P newportbeachca.gov/inspections Combination Type - Work Class - New F 2 0 2 3 0 1 7 2II COMB Permit : F2023-0172 Plan Check No : 1804-2019 Issued Date : 04/18/2023 _ Inspection Area fzj;�> 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: 393 HOSPITAL RD SOUTH Legal Dose: A TR IRVINE SUB BLK 2 LOT 169 IRVINE SUB LOT 169 BILK 2 POR O F LOT AS DESC IN Description: COMM FIRE ALARM "ATRIA SENIOR LIVING" (X2019-2135) (319 DEVICES) *CHANGE OF ADDRESS* ReVava—0-7 a Owner: NEWPORT BEACH PROPCO LP Contractor: A & D FIRE Architect : Address : Address: 7130 CONVOY CT Address PHOENIX, AZ 85050 SAN DIEGO, CA 92111 Phone : (916) 508-9801 Phone : (858) 277-3473 Phone Con State Lie : 1069002 State Lie : .... Lie Expire : 09/30/2024 Applicant: A & D FIRE Bus Lie: BT30073130 Engineer : Address : 7130 CONVOY CT Bus Lie Expire : 10/31/2023 Address SAN DIEGO, CA 92111 Phone: (858) 277-3473 Workers' Compensation Insurance Phone: Carrier: AMERICAN ZURICH INS CO Owner/Builder : Policy No: WC4020292 Designer: A & D FIRE Address : W. C. Expire : 9/16/2023 Address : 7130 CONVOY CT SAN DIEGO, CA 921 %1 Phone: Phone: (858) 277-3473 Code Edition : 2016 Fire Sprinklers : NO Construction Valuation: Type of Construction : 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: 2 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone: PI - Private Institutions PROCESSED BY: �✓ SPECIAL CONDITIONS: TI ON 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 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 is 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 licensors 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). 3 1, as owner of the property, or my employees with wages as their sole compensation, will do i_) all of or U 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, as owner of the property, am exclusively contracting with licensed Contractors to Construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not ply 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), i am exempt from licensers 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 tegall, ell a structure that I have built as an owner buildor 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:htip:fiwww.leginfo.ca.gov/calaw.html. lignatum of Property Owner or Authorized Agent _ Date ACENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section)00) of ivisiDq 3 of the Business and Prot ion. , and my Iicens -In full force :rid effect. License Class License No Data ( 49 77-L__ contractor Signature% VORKERS' COMnuNSATION DECLARATION EARNING: FAILURE TO P£^.HPE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COR'. PENSATION, DAMAGEa AS PROVIDED FOR IN SECTION 370S OF THE LABOR CODE, INTEREST, AND ATTORNEY's Pass - he shy affirm under p€nalty, of perjury one of the following declarations: I I rive 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 th erformzr,ce 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 of Agent I eel iffy lost, in the perormance of the wor or 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 agree t, if I should be co . , q' )Ject to the w —7 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. f/ Ine!or1 it APPlicnnt II / Date CLARATION REfnA�ONSTR. LENDING AGENCY ' treby affirm under penalty of perjury that there is a construction lending agency for the performance ofthe work for which this permit is issued (Section 3097, Code). iders 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 1 have provided incorrect. I agree to comply with all applicable city and county or 'nances an aws relating to building construction. FFjf I authorize representatives of this city or county to t r the ve t!nfied properly for inspection purposes. Iv / nature of PrGDertv Owner or Authorized Aaenl / Print Prooenv Owner's or Authorized Acenl's Name u ACTION DATE BY iOECLARATION'-9F{-HMPLl/%NCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMO RULE. PERMITEXPIREO LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIELL LIEPA _ ter _. OAQMD PERMIFFINAi_- oL'tl�j �1D...ASRESTOS NOTIFICATVON IS NOT APPLICABLE TO CERTIFICATE of PROPOSED DEMOLITION OCCUPANCY155UED SIGNATURE: