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Home My WebLink AboutF2023-0505 - PermitsCity of Newport Beach 11111111111111111111111111111111111111111111111111111111111111111 JillCOMB Permit: F2023-0505 Dk ; w, Community Development Department - Building Division F 2 0 2 3 0 5 0 5 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2535 Permit Counter Phone: (949) 718-1888 Issued Date : 11/0812023 y 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: 4695 MACARTHUR CT, STE 355 Legal Desc : P BK 196 PG 40 PAR 2 Description: COMM FIRE ALARM TI -2 DEVICES (XC2023-0418) Owner: IRVINE COMPANY Contractor: DAVID SIMPSON CONSTRUCTION INC Architect Address Address : 110 INNOVATION DRIVE Address : TTE4AVE #A IRVINE, CA 92617 I17177 RVINE, CA Phone: (949)720-2000 Phone: (949)250-1348 Phone: State Lic Con State Lic : 381149 Lic Expire : 03/31/2025 Applicant : MARK YAM Bus Lic: BT00006013 Engineer Address : 392 N LEMAY CT Bus Lic Expire : 06/30/2024 Address ORANGE, CA 92867 Phone: (626) 757-2320 Workers' Compensation Insurance Phone: Carrier: CYPRESS INSURANCE COMPANY Policy No: DAWC426822 Designer: BUILDING ELECTRONIC CONTROLS owner/Builder: W. C. Expire: 5/1/2024 Address: 2246 LINDSAY WAY Address : GLENDORA, CA 91740 Phone: (909) 305-1600 Phone: 2022 Fire Sprinklers : YES Construction Valuation : $1,579.00 Code Edition : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg : 0 Type of Construction : No of Units : 1 Alteration sq. ft. Bldg : Occupancy Groups : B No of Stories : 15 Added/New sq. ft. Garage : 0 Bldg Height: TOTAL sq. ft. : 0 Building Setbacks Flood Zone : X Use Zone : PC - Koll Center BY: PROCESSED SPECIAL CONDITIONS: CONDITIONS: —gr� OWNER -BUILDER I hereby affirm under penalty of perjury that I 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, 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 Ilia 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 for the alleged exemption. Any violation of Section 7031,5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 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). ❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not apply 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). 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature bolov+ 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 iegail, sell 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 Professions Code., is available upon request when this application Is submitted or at the following Web site;http://www.leginfo.ca.gov/calaw,btml. 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 a Di Won 3 of the Business and Profess'rc�ls Cod rid rpy license is In full force and effect. License Class License No Date f� G Contractor Signature A/ORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATrON COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1E100,000i, IN ADDITION TO THE DOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR GODS, INTEREST, AND ATTORNEY'$ FEES. hereby affirm under penalty of perjury one of the following declarations: -11 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, forth )erformance 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 Code, for the performance of the work for which this permit is issued. My workers' ranee carrier and policy number are: Policy Number Expiration Date of Agent 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 agre if I should become to thegy+jgrkkarss''�pompensation previsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Ialure of Applicant _.. G"7l Date .t_ARATiON RFt,,APF M. rfW:iQTR1 Ir Ini I CFIRI\I r] nnrury hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lenders Address _ y 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 slate laws relating to building construction. I authorize representatives of this city or cou mer I "above -identified property for inspection purposes. ^� J ignature of Property Owner or Authonzed Agent =Z-1 Print Property Owner's or Authorized AnarI Name ?-- l`ovsGs6�F� ACTION DATE BY ! DECLARATION OF COMPLIANCE WITii CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AONI D RULE 1403 FOR OFFICE USE ONLY PERMTEXPIREO jILLI SUBMITTED ASBESTOS NOTIFICATION TO CANCE'.EED ...PERMIT OAQMD PERMIT FINAL CERAFCATE Of \11�y �J ( LI�A5BESTOS NOTIFICATION IS NOI APPLICABLE TO ^ /ill PROPOSED DEMOLITION OCCUPANCY USGu' W [ SIGNATURE: