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Home My WebLink AboutF2023-0412 - Permits04'."", City of Newport Beach COMB Permit: F2023-0412 Community Development Department - Building Division F 2 0 2 3 0 4 1 2 10D Civic Center Drive, Newport Beach, CA 92650 Plan Check No : PC2023-2096 Permit Counter Phone: (949) 718-1888 Issued Date : 08129/2023 newportbeachca.gov/civic Final Date: Combination Type - Permit Status: Issued Work Class - Tenant Improvement 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 : 100 BAYVIEW CIR, 4200 Legal Dose : N TR 12528 ELK LOT 2 Description : COMM FIRE ALARM - 1 DEVICE (XC2023-0201) Owner: GPI BAYVIEW LLC Address : 5601 GRANITE PKWY STE1200 PLANO, TX 75024 Phone Applicant: MIRIAM GOMEZ Address: 1354 S PARKSIDE PL ONTARIO, CA 91761 Phone: (909)957-5200 Owner/Builder : Address: Phone Contractor: H C I SYSTEMS INC Address : 1354 S PARKSIDE PL ONTARIO, CA 91761 Phone: (909)628-7773 Con State Lie : 905493 Lie Expire : 02/29/2024 Bus Lie: BT30042287 Bus Lie Expire : 02/29/2024 Workers' Compensation Insurance Carrier: FEDERAL INSURANCE COMPANY Policy No: 54309498 W. C. Expire: 3/2/2024 Architect Address Phone: State Lie Engineer: Address: Phone Designer: GARY RAMIREZ Address : 1354 S PARKSIDE PL ONTARIO, CA 91761 Phone: (909)957-5200 Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $918.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Occupancy Groups : B No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 6 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X . a Use Zone : PC - Bayview PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale 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 i'fcensdre 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).. 0 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, 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 apply 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). ❑ 1 am exempt from licensors under the Contractors' Stale 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 legally sell a structure that I have built as an ov Der -builder if 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:httpaiwww.leginio.ca.govlcalaw.html. Signature of Property Owner or Authorized Agent—_ __ Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700) f D'vis'an 3 of the Business and Professions gp� and r�. Be is In full force and effect. License Class License No Date �3 Contractor Signature f "/ C WORKERS' COMPENSATION DECLARATION n f � WARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,000j, IN AOCRION To THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEEs hereby affirm under penalty of perjury one of the following declarations: I have and will maintalh a certificate of Consent to sell -insure for workers' Compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for Patience of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Date is of Agent Phone # certify that, in the performance of the work for which this permit is issued., I shall notemploy any person in any manner so as to become subject to the workers' compensation taws of California, and agree , if I should become subject to th orkers' compensab �Upons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Toluca of Applicanll Da,e 01 1�-a +1 h0l1 YYI'lAI OCl�I.OI'il Alf± AA,CTOIIIYII\AI IC\ ^^f+ AI+CAIhV J =_reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is Issued (Sectlon 3097, Civil Code). idar s Name _ Lender`s Address 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 county ordinances and state laws relating to building. construction. I authorize representatives of this city or county to enter abpye-idenfifde pe y for inspection purpocrs ((/ /��/� iaailua of Pmnanv Ownar or Aulhodzari AGenl A/ � \ int Prooartv Owner's c, Auth^rize� Ac.enCs Name . (� `� ACTION DATE. By DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL rCR OfECE UK OALS RFGULATIONS PART 61 OF TITLE 40 AND AQMD RLRE PERM T EXPIRED U I SUBMitT€DASBF5TCS NOTIFICATION TO PERWIT &IVCELLED P€RmfiT FXTENDFD IJAQM D NOT IFICA PION 15 NOT APPLICABLE TO CERTIFICATE OK i -c I j PROPOSED DEMOLITION OCCUPANCYISSUED , SIGNATURE: