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HomeMy WebLinkAboutF2023-0078 - Permits�yW��O�T City of Newport Beach COMB Permit : F20230078 S�-. Community Development Department- Building Division F 2 0 2 3 0 0 7 8 Plan Check No : PC2023-0313 > Y ,y 100 Civic Center Drive, Newport Beach, CA 92660 '= i< Permit Counter Phone: (949) fi44-3288 r. Issued Date : 04/17/2023 Inspection Requests Phone: (949) fi44-3255 Inspection Area :FIRE 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 TICK) /k),J'T- SPAC-C- i2,eS'Ta0&LL,( S Job Address: 4675 MACARTHUR CT, 2ND FLR Legal Desc : P BK 196 PG40PAR .3 Description: COMM FIRE ALARM TI W/ 10 DEVICES (XC2023-0039) f--? Owner: IRVINE CO Contractor: SIMPSON DAVID CONST CO INC Architect Address : 111 INNOVATION Address'. 17177 GILLETTE AVE #A 92614 Address IRVINE, CA 92618 IRVINE, CA �+ Phone: (949)720-3100 Phone: (949)250-1348 Phone: Con State Lie : 381149 State Lie Lie Expire : 03/31/2025 r Applicant : MARK YAM Bus Lie: BT00006013 Engineer Address : 392 N LEMAY CT Bus Lie Expire : 06/3012023 Address ORANGE, CA 92867 Phone: (626) 757-2320 Workers' Compensation Insurance Phone: Carrier: CYPRESS INSURANCE COMPANY / Owner/Builder : Policy No : DAWC324566 Designer: BUILDING ELECTRONIC CONTROLS Address : W. C. Expire : 5/l/2023 Address: 2246 LINDSAY WAY GLENDORA, CA 91740 Phone: Phone: (909)305-1600 Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $3,805.00 Type of Construction : I -A 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 : 15 Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 Building Setbacks Flood Zone : X Use Zone : PC - Koll Center PROCESSED BY: (� SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affiml 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 arty or county Ytwt requires a permit to construct, alter, improve, darer ish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a s€gnod statement that lieor she is licensed pursuant to the provisions of the Contractors' State License L w (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from leansure and the basis for the alleged exemption. Any violation of Septic 7031.E by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundreddollars ($500)... 11 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of tit i 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 ts iplayees'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 dompll lion, the Owner-Builderwill have the burden of provingthat 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, E usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor I ursuant to the Contractors' State License Law). © 1 am exempt from lurensum 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 y ar prior to completion of the improvements covered by this permit, I cannot legaltl soil a structure that I have built as an owner-buildor if it has not been constructed in its entirety by licensod contractors. I and ITstand 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:hftp:fAvww.leginf .ca,gov)calav+,htmI Signature of Property Owner or Authorized Agent �f LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commencing with Soctf D00 -f f the Business and P salon 4,canse is In full force and effect License Class License No Contractor SignaI4 WORKERS' COMPENSATION DECLARATION (YARNING: FAILURE TO SECURE WORKERBCOMPENSATION COVERAGE 13 UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALIT IS AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100rII00), IN ADDITION To THE COST OF COMPENSATION; DAMAGEa AS PROvicFn FOR IN SECTION 3MS OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES, Ihereby affirm under penalty of perjury one of the following declarations: r u I have and will maintain a certificate of consent to self- insure for workers' compensation, issued by the Director of I idusinal Relatlons as provided for by Section 3700 of the Labor Cade, for IN p,p�tatrformance of the work for which this permit is issued. Policy No. '!`"ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the ped Dmiance of the work for which this permit is issued. My workers' eomponsatior insurance carder and policy number are Carrier Policy Number Expiration Date Name of Agent 1 Phone # QI certify that, in the performed of a work for h this pa I Issued, I shall not employ any person in any manner sc as to become subject to the workers' compersation laws of California, and agree that, if I should beco eject t workers' co nsation €stons of -Section 3700 of the Labor Code, I shall forthwith i amply with those provisions. Signature of Applies t Date--i/` DECLARATION RE RD' ONSTR. 710. LE AGEN hereby affirm under penalty o perjury that there is a construction lending agency for the performance of the work for which is permit is issued (Section 3097, Clv. Code). tenders Name Lender's Address By my signature below, I certify to each of the following I am the property owner or authorized to act on the property owner's Denali, I have read this application and the information I have provided I sect. 1 agree to comply with all applicable city and c?UlItty ordinance it state I' relating t0 building construction. I authorize representatives of this city or count. enter the a - lit p party for inspacbon purposes. , I Si nature of Property. Owner or Authorized A ent Print Property Owner's orAuth Prized Agent's Name ate ACTION DATE f BY DECLARATION Of COMPLIANCE WITS[ CODE. OF FF. DERAL FOROFFICE SEONLY , I REGULATIONS PART fit OF TITi.E 40 AND AQNTD RULE 1403 PERMIT r XPIRED ISUBMirTED A.sit -T<,. NGTIFICATIGN TO PERMIT CANCE A.__.....LLEL? _j.__.... .....__� CII PA_-_ PERYfiT EXTENl1EO QMp PERMIT PJNAL // j'LU ASBESTOS NOT( IC ' ON 5 PPLICABLIE TO CF9PPtC4TE OF PROPOSED ` OCCUPANCY ISSUED SIGNATUR _