HomeMy WebLinkAboutF2023-0084 - Permitsc�.wpo,y
City of Newport Beach
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Development Department- Building Division
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COMB Permit:
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100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No : PC2023-0348
Permit Counter Phone: (949) 644-3288
Issued Date : 02/15/2023
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Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
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Inspection Area : FIRE
Combination Type-fi.r
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
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Job Address : 100 BAYVIEW CIR, 3200
Legal Desc : N TR 12528 BLK LOT 2 r�
Description: COMM FIRE ALARM TI W/ 6 DEVICES "SIGNATURE BANK" 2703 SF X C oL-C)L -�
Owner: GPI BAYVIEW LLC
Contractor: H C I SYSTEMS INC
Architect
Address : 5601 GRANITE PKWY STE1200
Address : 1354 S PARKSIDE PL
Address
PLANO, TX 75024
ONTARIO, CA 91761
Phone :
Phone: (909) 628-7773
Phone:
Con State Lie : 905493
State Lie
Lie Expire : 02/29/2024
Applicant : H C I SYSTEMS INC
Bus Lie : BT30042287
Engineer
Address : 1354 S PARKSIDE PL
Bus Lie Expire : 02/28/2023
Address
ONTARIO, CA 91761
Phone: (909) 628-7773
Workers' Compensation Insurance
Phone:
Carrier: FEDERAL INSURANCE COMPANY
Owner/Builder :
Policy No : 54309498
Designer: H C I SYSTEMS INC
Address :
W. C. Expire : 3/2/2023
Address : 1354 S PARKSIDE PL
ONTARIO, CA 91761
Phone:
Phone: (909) 628-7773
Code Edition : 2022
Fire Sprinklers : YES
Construction Valuation : $1,997.00' ,
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 : 6
Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
Building Setbacks
Flood Zone : X
,
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 reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, alter. improve, demolish, or repair any structure, prof 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' 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 forthe alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civilpenalty of
not more than five hundred. dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sale compensation, will do f_) 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 sate. If, however, the building or improvement is sold %!thin one year of completion, the Owner -Builder will have the burden of proving that it was not built of
improved for the purpose of sale). 1,
❑ 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 net
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). —
❑ I am exempt from licensers under the Contracors' State License Law for the following reasen:
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 owner 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, isavailable upon request when this application is submitted or at the following "Web site:http:/,' w.leginfo.ca.gov/calaw.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 70 0 of Divi 1 3 of the Business and Professions Q , and m 'eensa is in full force
and effect. License Class License No Date G Contractor Signature
.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 THOUSAN••U DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 1706 OF THE LABOR CODE, INTEREST. "a ATTORNEY'S Fees.
''.I hereby affirm under penalty of perjury one of the fallowing declarations:
111 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 the
performance 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 Cade, for the performance of the work for which this permit is issued. My Workers'
ranee carrier and policy number are:
Policy Number
of Agent
Date
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 agref
if I should become subject to the y6o s'-comp sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 2
lature of Applicant DateOZ,� Z")
zraby affirm Linder penalty of perjury that there is a construction lending agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Code).
.ear's Name Lender's Address
my signature welr,w, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have rose this application and the information I have provided is correct.
I agree to nnmply with all applicable city and county ordinances and state laws relating to building construction.
I authorize reprasentahves of this city or county to,�rter the abowe idenffied property for inspection purposes.
or Authorized Agent 1 v - l/V — Print Property Ovinera or Authorized Ag
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE
I SVBMITTFD A50F,STOS NOTIFICATION TO
PERMIKX :f`E0 L3AQMD
PERMITFINAL Q(P <1?) (ft/ Is ❑ASBESTOS NOTIFICATION SNOT APPLICABLE TO
CERTIFICATE OF O PROPOSED DEMOLITION
OCCUPANCYISSUED j SIGNATURE:
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