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Home My WebLink AboutF2022-0456 - PermitsCity of Newport Beach ��EWP0,4T ' @ Community Development Department - Building Division �^✓ _ "ty 100 Civic Center Drive, Newport Beach, CA 92660 U T Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 Cq</FORH�P newportbeachca.gov/inspections Combination Type - Work Class - Tenant Improvement COMB Permit: F2022-0456 Plan Check No : PC2022-2127 Issued Date : 10/07/2022 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 : 20350 BIRCH ST, 202 Legal Desc : P BK 385 PG 30PAR 1 Description: COMM HOOD FIRE SUPPRESSION SYSTEM (X2021-3309) Owner: NEWPORT HEIGHTS MEDICAL OFFICE LLC Address : 2141 ROSECRANS AVE #610 EL SEGUNDO, CA 90245 Phone Applicant: LETICIAHADEN Address : 3621 EAGLE ROCK BLVD LA, CA 90065 Phone: (323)259-9999 Owner/Builder Address : Phone: vGt Tt�1`1S .�(�►a�r+� Contractor: EDISON FIRE EXTINGUISHER CO INC Address : 3621 EAGLE ROCK BLVD LOS ANGELES, CA 90065 Phone: (323)259-9999 Con State Lic : 569185 Lic Expire : 05/31/2023 Bus Lic : ST30069740 Bus Lic Expire : 07/21/2023 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No : 9066898 W. C. Expire : 8/1/2023 Architect Address Phone: State Lic Engineer: Address Phone: Designer: LETICIA HADEN Address : 3621 EAGLE ROCK BLVD LA, CA 90065 Phone: (323)259-9999 Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : $2,000.00 Type of Construction : II-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : , Bldg Height: No of Stories : 2 Added/New sq. ft. Garage : 0 - - TOTAL sq. ft. Bldg : 0 Building Setbacks : ' •' ' Flood Zone: X ,. Use Zone : SP-7 - Santa Ana Heights Specific Plan PROCESSED BY: 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 checkmarke) 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 rapair any structure, prior to its issuance, also requires the applicant for he 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 lot more than five hundred dollars ($500). 1 I, 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 not intended or offered for sale (Section 7044, justness 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 mprovements 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 mproved for the purpose of sale), 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 I�rply 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). J I am exempt from licensors under the Contractors' State License Law for the following reason iy 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 legall ,all a structure that I have built as an owner -builder if it has not been constructed in its enurety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rafessions Code, is available upon request when this application IS Submitted or at the following Web site:j li'wvrw.legfnfo.ca.govlcalaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I are licensed under provisions of Chapter 9 (commencing with Section 7000) of Div n 3 of the Business and (rr .. I WTTR. / I ns i ull force Ind effect. License Class License No Date l0/ Contractor Signatu NORKERS' COMPENSATION DECLARATION DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND OOLLAR91E100,000L M ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR LODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the fallowing declarations, I 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 tt erforruence of the work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, es required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers comperearfol Tence carrier gn poln nber RE: y p ter .lL�, i Policy Number Expiration Date is of Agent 22 Phone it certify that In the erformance IT the w�Xfor which this per Is issued, I shall not emptoy any person in any manner so as to become subject to the workers' compensation laws of California, and ogre If I shuuid'. beuo to aubject a an roves r5s of Sealion 3700 of the Labor Code, I shall forthwith comply with those previsions. lalure at Applicant 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 Roper's Name_ _ c__ _ __ _ Lender's Address _b y my signature elow, I ertify to each of the following: --- 1 am the ,)-c,l.n'.t owner or authorized to act on the property owner's behalf. /�L L have read this application and the informal' n I have provided i,L ' Xrract I.agree to comply with all applicable city a county ordinan 5 f1 to laws relating to bul(tling construction. I authorize representatives of this city or c my to enter , iq i� pr� far ins ectlon purposes. ionbture of Pr000rtv Owner or Authonzed Aaent _ ii Print Prnnanv Owner's or Alrthnri�ed AaenlA Name I ACTION I` DATE BY { DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I REGULATIONS PART 61 OF TITLE 40 AND AQMO RULE 1403 FOR OFFICE USE ONLY j PERAWEXPIR50 [LJ I SUBMITTED ASBESTOS NOTIFICATION TO EPA PERMIT CANCELLrE7— 'EPoWITENTE➢!C'ED ....._.— v L1gOMD PERMITFINAL ��t1� krA5BE5TO5NOTHH N NOT CABLE TO __'_' CERT9CATEOF I` r S PRO POSED D MO OCCUPANCY ISYJ4) `; SIGNATURE: Civil Code). rj Aqi Date le