HomeMy WebLinkAboutF2023-0538 - PermitsD�aEWnoRT City of Newport Beach
O Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
i) ¢ Permit Counter Phone: (949) 718-1888
n. newportbeachca.gov/civic
cgt�FoaN'P Combination Type -
Work Class - Tenant Improvement
iiiiiiiiiii II
COMB Permit: F2023-0538
Plan Check No : PC2023-2669
Issued Date . 11/01/2023
Final Date:
Permit Status: Issued
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: 809 NEWPORT CENTER DR Legal Desc : P BK 221 PG 30 PAR 6 P.M. 221-30 PAR 6 POI�i OF PAR
Description: COMM FIRE ALARM TI WITH 28 DEVICES FOR "GOOD AMERICAN" (XC2023-0208)
Owner: IRVINE CO
Address : 111 INNOVATION
IRVINE, CA 9261E
Phone: (714)366-7205
Applicant: RICHARD JOHNSON
Address: 3750 SCHAUFELE AV, 200
LONG BEACH, CA 90808
Phone: (562)353-4680
Owner/Builder :
Address :
Phone
Contractor: INTERFACE SYSTEMS
Address : 3750 SCHAUFELE AV, 200
LONG BEACH, CA 90808
Phone:
(562)353-4680
Con State Lie
: 469046
Lie Expire :
08/31/2025
Bus Lie:
BT30046473
Bus Lie Expire : 03/31/2024
Workers' Compensation Insurance
Carrier: TRAVELERS PROPERTY CASUALTY CO OF
AMERICA
Policy No: UBOK0634482243G
W. C. Expire : 10/1/2024
Code Edition : 2022
Fire Sprinklers :
YES
Type of Construction : III-B
Fire Hazard Zone :
NO
Occupancy Groups : M
No of Units :
0
Bldg Height :
No of Stories :
1
Building Setbacks
Flood Zone : X
Use Zone: PC - North Newport Center
PROCESSED BY: ap
SPECIAL CONDITIONS:
Architect
Address
Phone:
State Lie
Engineer
Address
Phone:
Designer: INTERFACE SYSTEMS
Address: 3750 SCHAUFELE AV, 200
LONG BEACH, CA 90808
Phone : (562) 353-4680
Construction Valuation : $12,000.o0I
Added/New/Tl sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Acided/New, sq. ft. Garage: 0
TOTAL sq. ft. 0
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that € am exempt from the Contractem' State License Law for the reason(s) indicated below by the checkmark(si I have placed next to the applicable items)
(Section 70315, 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' 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 licensors 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 U all of or U portions of the work, and the structure is not intended cr 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 properly, provided that the
'improvements are not intended or offered for sale. If, however, the building or Improvement is sold withinone year completion, the Owner -Builder will have the burden of proving that it Wes not built or
improved for the purpose of sale).
0 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' Stale License Law).
l0 I am exempt from licensure under the Contractors' Slate License Law for Ate 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 owner -builder if It has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 70" of the Business and
Professions Cade, is available upon requestwhen this application is submitted or at the following Web site:http:flvwnv.ieginfo.ca.gov/calawthtml.
Signature of Property Owner or Authorized Agent a e
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commending with Section 70 0 f Division 3 of the Business and Proles if n license is in full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION t I
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 (E1U4000j, IN AoordON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE., INTEREST, AND ATTORNEY'S FEES..
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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
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 Code, for the performance of the work for which this permit is issued. My workers'
lance carrier and policy number are:
to of Agent
certify that,in the perrormanyp of the work
. if I should become subject�i tp� orker
iatura of Applicant V% �lC/ (J
Policy Number Expiration Date
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
ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. If- I
Date - Z Z
hereby affirm urcwr ,eralty 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).
enders Name [ Lender's Address
r: ,r,y s,g„rature below, Icertify to each of the Following:
I am the properly owner or authorized to act on the property owner's behalf.
I hay., read thisapplication and the Information I have provided is orrect.
agree to Domp'I v Rh all applicable city and county, di n nd state laws relating to building construction,
I auth-cnze rep-rs?nlatives Of this city or county tove-identified property for inspection purposes, '
'signature of Property Owner or Authorized Agent Print Prooarty Owners or Authorized Acenta Name t�i,r Le.,, A. —C.� —
ACTION
F?RMIT CQNCELLCD
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DATE I BY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
I SUBMITTED ASBESTOS Nom ncATION TO
L1. ASBESTOS NOTIFICATION 15 NOT APPLIC"ARLE TO
PROPOSED DEMOLITION
FOR OFFICE USE ONLY
ICI