HomeMy WebLinkAboutF2024-0005 - Permit Application�EWPORT City of Newport Beach ��IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �� COMB Permit F2o24-0005
Community Development Department- Building Division F 2 0 2 4 - 0 0 0 5
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2024-0009
G = Permit Counter Phone: (949) 718-1888 Issued Date : 01103/2024
.a.. newportbeachca.gov/civic Final Date:
cgUcOs<Tr�f Combination Type - �' ?'.e � Permit Status: Issued
Work Class -Tenant Improvements° °"`y r Illc i 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 : 2523 EASTBLUFF DR
Legal Desc : P BK 49 PG 22 PAR 2. PM 49-22 PARS
2,3 & POR PAR 1.
Description: COMM FIRE SPRINKLER TI WITH 25 HEADS TO REMOVE (E) SPRINKLER SYSTEM "STARBUCKS"
(XC2l
Owner: IRVINE COMPANY
Contractor: FIRE SAFETY FIRST
Architect
Address: 111 INNOVATION DRIVE
Address : 1170 E FRUIT ST
Address
IRVINE, CA 92617
SANTA ANA, CA 92701
Phone : (949) 720-2400
Phone : (714) 836-4800 x137
Phone
Con State Lie : 599761
State Lie
Lie Expire ; 08/31/2024
Applicant : FIRE SAFETY FIRST
Bus Lie: BT00009906
Engineer
Address : 1170 E FRUIT ST
Bus Lie Expire : 06/30/2024
Address
SANTA ANA, CA 92701
Phone: (714) 836-4800 x137
Workers' Compensation Insurance
Phone:
Carrier: REPUBLIC INDEMNITY COMPANY
OF
AMERICA
Owner/Builder :
Policy No : 2569801
Designer: FIRE SAFETY FIRST
Address :
W. C. Expire : 11/1/2024
Address : 1170 E FRUIT ST
SANTA ANA, CA 92701
Phone:
Phone: (714) 836-4800 x137
Code Edition : 2022
Fire Sprinklers : YES
Construction Valuation : $1,500.09...
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Tl sq. ft. Bldg : 0 .. ,
Occupancy Groups : B
No of Units : 0
Alteration sq. ft. Bldg : I ; ,
Bldg Height:
No of Stories : 1
Added/New sq. ft. Garage: 0
TOTAL sq. ft. 0
Building Setbacks
Flood Zone : X
> >
Use Zone : CN - Commercial Neighborhood
BY:
PROCESSED
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm underpenalty of perjury that l am exempt from the Contractors' Slate 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, after, Improve, demolish,, or repair any structure, prior to its issuance, also requires the applicant for
Te 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
'rofessions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Section 703L5 by any applicant for a permit subjects the applicant to a civil penalty of
OF more than five hundred dollars ($500).
7 h as owner of the property, or my employees with wages as their sole compensation, will do L_) all of or L) portions of the work, and the structure is not intended' or offered for safe (Section 7044,
lustiness 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 sold within one year of completion, the Owner -Builder will have (lie burden of proving that it was not built or
nproved 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 not
ply 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 Lew).
I am exempt from Iicensure under the Contractors' Slate License Law for the following reason:
ly 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
oil a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:llwww•.leglnfo.ca.govfcalaw.html.
lignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) n Divlsibn 3 of the Business and Professi o f , y ' enseis in full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
1ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL EWES UP TO ONE HUNDRED THOUSAND DOLLARS 0,000F IN ADOTION TO THE
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:
7 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 IN
%formance 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:
to of Agent
certify that, in the performance of the work for
if I should become subject kG;H w9fk9P9) cc
of Applicant
Policy Number
Date
this permit is issued, I shall not employ any person in any manner so as to bacome subject to the workers' compensation laws of California, and agree
ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ' /
4______ _,_. Data t —3 2 T
ireby affirm under penalty of perjury that VaDrW is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code),
Iders Name I Lender's Address
my signature bnlmv, I certify to each of the following:
I rm the property owner or authorized to acton the property owner's. behalf.
I have reao this apnlicatibn and the Information I have provided is cc fact.
16oree to comply with all applicable city and county or ante an s to laws relating to building construction.
sulhorfze representatives of this city or county to t v - ntified property for inspection purposes. D 1�.
nature of Pruperry Gwner or Authorized Aaenl Pant Prooertv Owner's or Authorized Aaents Name /\ t r, K ✓ l,1,1 kC'-
ACTION
F:i17r,t:T EXPIRED
PERMIT CANCELLED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY f55UED
DATE I BY
PART 61 OF TITLE 40AND AQMD RULE
1403
13 1 sUBMITT'ED ASBESTOS NOTIFICATION TO
EPA
L ASHES FOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION °
SIGNATURE:
FOR OFFICE USE ONLY