HomeMy WebLinkAboutF2023-0309 - Permits�EwPoRT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : F2023-0309
D� @ Community Development Department- Building Division F 2 0 2 3 0 3 0 9
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1497
u i Permit Counter Phone: (949) 718-1888 Issued Date : 0612112023
« newportbeachca.gov/civic Inspection Area : FIRE
°94conN`" 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
Job Address : 4321 BIRCH ST (O f e) Legal Desc : N TR 5169 BLK LOT 5
Description: FIRE SPRINKLER TI (2ND FLR) "KIND BODY" (XC2022-1855) 13 HEADS
Owner: 4321 BIRCH PARTNERS LTD
Address : 668 N COAST HWY #1370
LAGUNA BEACH, CA 92651
Phone
Applicant: TOP LINE FIRE PROTRCTION INC
Address : 13844 ALTON PKWY #133
IRVINE, CA 92618
Phone: (949)299-7949
Owner/Builder
Address :
Phone
Contractor:
TOP LINE FIRE PROTRCTION INC
Address :
13844 ALTON PKWY #133
IRVINE, CA 92618
Phone:
(949)299-7949
Con State Lie
: 944213
Lie Expire :
09/30/2024
Bus Lie:
BT30081354
Bus Lie Expire : 04/30/2024
Workers' Compensation Insurance
Carrier: PALOMAR SPECIALTY INSURANCE
COMPANY
Policy No: PSIC1110803
W. C. Expire : 4/1/2024
Code Edition : 2022
Fire Sprinklers :
YES
Type of Construction : V-B
Fire Hazard Zone :
NO
Occupancy Groups : B
No of Units :
0
Bldg Height:
No of Stories :
2
Building Setbacks
Flood Zone : X
Use Zone: OA - Office --Airport
PROCESSED BY:
SPECIAL CONDITIONS:
Architect
Address
Phone:
State Lie
Engineer:
Address: •>>>
Phone
Designer: TOP LINE FIRE PROTRCT:OPI iNC
Address: 13844 ALTON PKWY #133
IRVINE, CA 92618
Phone : (949) 299-7949
Construction Valuation :
Added/New/TI sq. ft. Bldg:
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage:
TOTAL sq. ft. :
CA \,K,\
151-9G. - 1�3Q
$2,000.00
0
0
0
OWNER -BUILDER DECLARATION
I hereby affirm under penally 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 tennis)
'action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, after. improva, demolish,. or repair any structure, prior to its issuance, also requires the applicant for
is permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Caw (Chapter 9 (commencing with Section 70001 Division 3 of the Business and
rofessions 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 for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
3 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) 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
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 the burden of proving that it was not built or
nproved 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
ply 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).
I am exempt from licensure under the Contractors' State License Law for the following reason: —
Iy 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
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:(iwww.leginfo.ca.gov(calaw.htmi.
ilgnature of Property Owner or Authorized Agent Date
.ICEII CONTRACTOR'S DECLARATION
hereby affir.n under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ) of Division f the Business a ro �aior,)s Code, and Is ly icense is In full force
nd effect. Li f nsR Class License. No D Contractor Sign ++{{llllJJ '�`�l
VORKERE' COMPENSATION DECLARATION
IAkNING: FAILUR. TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMM L PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000), IN ADDrrION TO THE
AST OF COMPERSAT-5.1, 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 I have and MIT 1"Intaln a certificate of consent to selfinsure for wo(kers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th,
vrrmance 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 Cade, for the performance of the work for which this permit is issued. My workers'
carries and policy number are:
Policy Number
or Agent
Date
;edify that, in the performance of the work for which this permit is issued, I shelf not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r- 7
ature ofAppV • nt
amby affirM-Un—der penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
tder'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 andthe information I have provided is correct.
I agree to comply with all appl a city and county ordinances and state laws relating to building construction.
I authorize representatives of this ci or court ft a�ry,er the above-i¢ernified property for inspection purposes.
'inaOlre of Prnnnrt4 OwnaY nr Auth rued AOP_nt UI k( I✓' ir-c-) Print Prooertv Owner's Or Authorized Aoenl
ACTION I DATE. BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT r4NCEU ED
OEPA
PERMIT EXTENDED
D
PERIVI FINAL
a- IQ a.?)
j�\S
AgiI;Tp5 NOTI FICA IION 15 NOT APPLICABLE TO
CERTIFICATE OF
PROPOSED DEMOLITION
OCCUPANCYISSUED
SIGNATURE:
id n 3197, Civil Code).
Date