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HomeMy WebLinkAboutF2022-0461 - Permits�,ewpoRT City of Newport Beach_ IIII IIIIIIII IIII II II III D� p Community Development Department- Building Division COMB Permit : F2022-0461 > y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-2177 ~ '� Permit Counter Phone: (949) 644-3288 Issued Date : 08/29/2022 U c r i Inspection Requests Phone: (949) 644-3255 Inspection Area : 3 All OOR", newportbeachca.gov/inspections Combination Type - Work Class - Tenant Improvement 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 0 C t t-toY5 -4-4 AWL rJ l �a- Job Address : 20350 BIRCH ST Legal Desc : P BK 385 PG 30 PAR 1 Description: COMM FIRE SPRINKLERS 10 HEADS (X2021-3309) Owner: NEWPORT HEIGHTS MEDICAL OFFICE LLC Contractor: COSCO FIRE PROTECTION INC Architect Address: 2141 ROSECRANS AVE #610 EL SEGUNDO, Address : 1075 LAMBERT RD, BLDG D BREA, CA Address CA 90245 92821 Phone Applicant: COSCO FIRE PROTECTION INC Address : 1075 LAMBERT RD, BLDG D BREA, CA 92821 Phone: (714)974-8770 Owner/Builder : Address Phone: Phone: (714)974-8770 Con State Lie : 577621 Lie Expire : 09/30/2023 Bus Lie: BT00022773 Bus Lie Expire : 07/31/2023 Workers' Compensation Insurance Carrier: ACE+AMERICAN+INSURANCE+COMPANY Policy No : WLRC68917396 W. C. Expire : 1/1/2023 Phone: State Lie Engineer: Address: Phone: Designer : COSCO FIRE PROTECTION INC Address : 1075 LAMBERT RD, BLDG D BREA, CA 92821 Phone: (714)974-8770 Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $6,500.00 Type of Construction : II-B Fire Hazard Zone : No Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 2 Added/New sq. ft. Garage : 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 penally of perjury that 1 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 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 (squires the applicant for the 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 Professions 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 not more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all Of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 improvements 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 improved 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 raprply 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 front licensure under the Contractors' State License Law for the following reason By 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 legalll sell a structure that I have built as an owner-bulldor it 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http:l/www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Dale . LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of gg��(jury t t))I �am licensed under provisions of Cha r 9 (co Fencing with Section 0 6) of Divisiol 3 of the Business and Pnd my license is in full r e and effect. License Class C_.- fo License No % ( � Dat ontractor Signatur WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T OUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNET's FEES. I hereby affirm under penalty of perjury oneof the following declarations: �© 1 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 th perforrydnce of the work for which this permit is issued. Policy No. ,bave 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' compensatiol wane carrier and policy number are: Tier Policy Number Expiration Date re of Agent Phone # certify that, in the performance of the work for which this permit is issued, I shall not employ any parson in any manner so as to become Is to tha workers' co pensation laws of California, and afire if I should Deco Ubfect the worker�ampyrr(f Ion provisions of Section 3700 of the La6ar Code, shall forthwith comply with those provisions. /� nature of Appiroa. D 1 ��Z 7 ,� CLARATION RE RDt CONSTRUCTION LE DING AGENCY Ireby affirm under penalty o t there m a construction lending agency for the performance of the work for which this permit is issued (Section 309T, Civi ode}. ider's Name Lenders Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the properly 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 CIRO ordinances and slate laws relating to building construction. I authorize representatives of this city or noun k4Fr�'<�eveyiden�tifie�d pr—ooe—rt�SorJnapec#ion�+lrposes. X� /� nature of Prooartv Owner or Authorized Aeent � ��i__�L Print Property Owner's or Authorized Aaent's Nary�i2 k —T- 1"0/fil Datay b�� /Z ACTION DATE By DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART El OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIPFO pI S'URMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLEn _L-.EPA. All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall I be in lace nor to approval to fillpool/spa & shall remain in lace & be maintained for the FERMiTEMENOED I (� u. { �-I L.JA_QMD P P PP P PERMITFINAL '� 1 3 3rt,.{t�(`( �I ASB[51'OS NOl'IFICATION IS NOT APPLICABLE TO life of the pool. CERTIf1CATE OF _ [4 PROPOSED DEMOLITION OCCUPANCY ISSUED v SIGNATURE: