HomeMy WebLinkAboutF2022-0114 - Permits (3)o��EwaoRe City nit NewportBy Development Pamhnt- BuildingDivision F 2 0 2���� COMB Permit: F2022-0114
Fy 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 0590-2022
Permit Counter Phone: (949) 718-1888 Issued Date : 03/301 022
newportbeachca.gov/civic Inspection Area
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
Job Address: 393 HOSPITAL RD, NORTH Legal Desc : A TR IRVINE SUB BLK:2 LOT 169 IRVINE SUB LOT 169 BLK 2 FOR O F LOT AS DESC IN
Description : COMM FIRE SPRINKLER TI -462 HEADS (X2019-1471)
Owner: NEWPORT BEACH PROPCO LP
Address :
PHOENIX, AZ 85050
Phone: (916)508-9801
Applicant:
A & D FIRE
Address:
7130 CONVOY CT
SAN DIEGO, CA 92111
Phone :
(858) 277-3473
Owner/Builder
:
Address:
Phone
Code Edition :
Type of Construction
Occupancy Groups:
Bldg Height:
Building Setbacks
Flood Zone : X
Use Zone : PI - Private Institutions
PROCESSED BY:
SPECIAL CONDITIONS:
Contractor :
A & D FIRE
Address :
7130 CONVOY CT
SAN DIEGO, CA 92111
Phone:
(858)277-3473
Con State Lie
: 1069002
Lie Expire :
09/30/2024
Bus Lie:
BT30073130
Bus Lie Expire : 10/31/2023
Workers' Compensation Insurance
Carrier: AMERICAN ZURICH INS CO
Policy No: WC4020292
W, C. Expire : 9/16/2023
Fire Sprinklers : NO
Fire Hazard Zone : NO
No of Units : 0
No of Stories
Architect
Address
Phone:
State Lie
Engineer:
Address:
Phone
Designer: A & D FIRE
Address: 7130 CONVOY CT
SAN DIEGO, CA 92111
Phone: (858)277-3473
Construction Valuation :
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
I hereby affirm under penalty 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 iterate)
Section 7031 �5. Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, dernoiish, or repair any structure, prior to its issuance, also requires the applicant for
is permit to file a signed statement that lie 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
Irofesslons Code) or that he or she Is exempt from Hcensure 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
.ot more than five hundred dollars (S500).
1 1, as owner of the property, or my employees with wages as their sole compensation, will do 1_} all of or U portions of the work, and the structure isnot 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 said within One year of completion. the Owner -Builder will have the burden of proving that it was not built or
unproved for the purpose of sale).
.d 1, as owner of the property, am exclusively contracting with licensed Contractors fo construct the project (Section 7044, Business and Professions Code; The Contractors' State License Law does not
poly to an owner of Prop" 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' State License Law far the fallowing reason:
ty 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 lagail
oil a structure that I have built as an ownor•builder if it has not boon constructed in its entiroty 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:llwww.loginfo.ga,gov)caiaw.'htmi,
'signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under previsions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and any license is In full force
,rid effect. License Class License No Date Contractor Signature,
VORKERS' COMPENSATION DECLARATION
rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 18 UNLAWFUL, AND SHALL SUSlECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL. FINES UP TO ONE HUNDRED THOUSAND DOLLARS t6100,0001, IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'a FEES_
hereby affirm under penalty of perjury one of the following 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
orromence 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`
Fence carrier and policy number are:
Policy Number
Date
ie of Agent Phone #
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 win those provisions.
tature of Applicant Date
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 Lenders Address
ly my signature below, 1 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 state laws relating to building construction.
I authorize representatives of this city or county to enter the above -Identified property for inspection purposes,
ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Anent's Name
ACTION I DATE
REGULATIONS. PART fit OF TITI.F 40 AND AOMD RULE
1403
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT FINAL
C011FICAFE � r j-- 125 —SIGNATURE: PROPOSED DEMOLITION
OCCUPANCY ISSUED
IS NOT APPLICABLE TO
FOR OFFICE USE ONLY