HomeMy WebLinkAboutF2023-0011 - Permits��EWPORr City of Newport Beach
D Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
ogcicoRH`P. newportbeachca.gov/inspections
Combination Type -
Work Class - Tenant Improvement
COMB Permit : F2023-0011
iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii II
Plan Check No: PC2023-0029
Issued Date :
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 : 2600 COAST HWY E, 2ND FL Legal Desc :
Description: COMM FIRE SPRINKLER TI - 2 HEADS (X2022-1118)
Owner: SMM LLC
Address : 2505 W COAST HWY STE201
NEWPORT BEACH, CA 92663
Phone:
Applicant:
JOEMCMILLEN
Address:
4065 LA PALMA AV E, A
ANAHEIM, CA 92807
Phone:
(714)630-0950
Owner/Builder :
Address :
Phone
Code Edition : 2022
Type of Construction : V-B
Occupancy Groups : B
Bldg Height :
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY
SPECIAL CONDITIONS
Contractor: ORTIZ FIRE PROTECTION
Address : 4065 E LA PALMA AVE, STE A
ANAHEIM, CA 92807
Phone: (744)-640-0950-
Con State Lic : 869383
Lic Expire : 12/31/2023
Bus Lic : BT30080359
Bus Lic Expire : 01/31/2024
Workers' Compensation Insurance
Carrier: AMERICAN FAMILY HOME INS CO
Policy No: 2EA5WC00012700
W. C. Expire : 10/1/2023
Fire Sprinklers :
YES
Fire Hazard Zone :
NO
No of Units :
0
No of Stories :
2
Architect
Address
Phone:
State Lip
Engineer
Address
Phone
J
Designer: TOM RAMBO
Address: 4065 LA PALMA AV E, A
ANAHEIM, CA 92807
Phone: (714)630-099�5O
Construction Valuation : $2,000.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq, ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft.: 0
OWNER -BUILDER DECLARATION
I hereby Billion 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 Item(s)
Ction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, derni or repair any structure, prior to its issuance, also requires the applicant for
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
fesslons Code) or that he or she is exempt from lloensure and the basis for the alleged exemption. Aoy violation oflSection '103L@ by any applicant for a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500)..
1, 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 proffered for sale (Section 7044,
;fness 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
rovements 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 bulls or
roved 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
€y 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).
J I am exempt from 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
sell a structure that I have built as an owner -builder if ithas not been constructed in its entirety by licensed contractors. I under,
Professions Code, is available upon request when this application issubmitted orat the following Web sim:htP:6www.leginfo.c.
Signature of Property Owner or Authorized Agent _
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti000) of Dit
and effect. License Class License No DM
COMPENSATION DECLARATION
ARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I I have and will maintain a certificate of consent to seiNnsum for workers' compensation, issued by the Director of lot
rfor lance 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 perfor
Is ranee carrier and policy number are:
:. rler Policy Number
is of Agent
certify that, in the performance of the work for which this permit is issued. I shall notemploy any person in any manner so
if I should become subject to the workers' compe provisions of Section 3700 of the Labor Code, I shall forthwith c
signature of Applicant
IECLARATION REGA I ONSTRUCTION LENDING AGENCY
hereby affirm under pa a ty of erjury that there is a construction lending agency for the performance of the work for which
enders Name Lender's Address
ly 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 I have provided Is correct.
I agree to comply with all applicable city and cc my ordinances and state laws relating to building construction.
I authorize representatives of this city or count it
the above -Identified property for inspection purposes.
ACTION I DATE I BY
PERMIT FXP7RE0
PERMfT UACEL! ED
PERMITEXTENDED
PERNRTFINAL
CER UFICATE OP l
OCCUPANCYISSUED i
CLULARATiON. OF COMPLIANCE W ITH CODE OF FEDERAL
RFGULATIONS PART Et OF TITLE 40 AND AQMD RULE
LJ ASBESTOS NOTIRCArION 15 NOT APPLICABLE TO
PROPOSED DEMOLITION
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
Date
13 of the Business and Profession a Code, and my license is In full force
Contractor Signature
CIVIL FINES UP TO ONE HUNDRED Tlielt§ND DOLLARS 131 DQ0001.. IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
to become subject to the workers' compensation laws of California, and agre
ply with those provisions.
Date_ ,�-4—Z�
permit is issued(Section 3097, Civil Code).
FOR OFFICE USE ONLY
G