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Home My WebLink AboutF2023-0257 - Permits�gWPOQT City of Newport Beach IIIIIII IIIIII�IIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : F2U23'U257 D� Community Development Department- Building Division F 2 0 2 3 0 2 5 7 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-1350 a D Permit Counter Phone: (949) 718-1888 Issued Data : 06/05/2023 u s newportbeachca.gov/civic Inspection Area : FIRE CgCIF00.N`P 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 eGVol w11or kv-(f aS d {2leS � � 'l- Job Address : 4440 VON KARMAN AVE .✓ F(/-1' Legal Desc : N TR 8762 BILK LOT 5 Description: COMM FIRE SPRINKLER MODIFY 37 HEADS (XC2023-0044/XC2023-0045) Owner : 4440 VKA TIC 3 LLC Contracfor : PACIFIC FIRE SUPPRESSION INC Address : 2727 LYNDON B JOHNSON FWY Address : 249 E EMERSON #G DALLAS, TX 75234 ORANGE, CA 92865 Phone: Phone: (714)283-0211 Con State Lic : 423418 Lic Expire: 11/30/2023 Applicant: PACIFIC FIRE SUPPRESSION INC Bus Lic: BT03042109 Address : 249 E EMERSON #G Bus Lic Expire : 03/31/2024 ORANGE, CA 92865 Phone: (714) 283-0211 Workers' Compensation Insurance Carrier: EVEREST NATIONAL Owner/Builder : Policy No: 5300004928211 Address : W. C. Expire : 9/17/2023 Phone: Code Edition : 2022 Fire Sprinklers : YES Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : B No of Units : 1 Bldg Height: No of Stories : 3 Building Setbacks : Flood Zone: X Use Zone; PC - Koll Center PROCESSED BY: SPECIAL CONDITIONS: Architect Address Phone: State Lic Engineer: Address Phone: D�signer : PACIFIC FIRE SUPPRESSION INC Address : 249 E EMERSON #G ORANGE, CA 92865 Phone: (714)283-0211 Construction Valuation : $5,000.00 Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage: 0 " TOTAL sq. ft. : 0 "" 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 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 toits issuance, also requires the applicant for to permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commenting with Section 7000) of Division 3 of the Business and rofessions Code) or that he or she is exempt from lieensure 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 of more than five hundred dollars ($500). I, Be owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness 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 lieensure under the Contractors' State License Law for the following reason: ,y 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 legall, all 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 Irofessions Code., isavailable upon request when this application is submitted or at the fallowing Web site:hUp9lwww.leginfe.ca.gov/calaw.html. signature of Property Owner or Authorized Agent _ Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7.0 1's' In 3 of the Business and P fe s nd y9ff—license is In full force rid effect. License Class License. No Date G Contractor Signatu VORKERS' COMPENSATION DECLARATION ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL EWES UP TO ONE HUNDREt 4USAND DOLLARS (Et00,000), IN ADDITION TO THE DST OF COMPENSATION: DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. V hereby affirm under penally of perjury one of the following declarations: have and will maintaina 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 rmance 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' III carder and policy number are: to of Agent _ certify that, in the p, If I should become Policy Number Date of the Irk 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 agm he ers' oompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �1 Cate IVY, IECLARATION REGARt3fl(i(j g)ONSTRUCTION LENDING AGENCY hereby affirm under penatf perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 ender's Name Lender's Address 7 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 Iniormatio have provided is correct. .,yr,:L to co ri I.Adi all applicable city and rdmances and state laws relating to building construction. I authorize repmsc,Yatives of this city o€ cou I y n,pr thezbeve-identi0ed property for inspection purposes. ACTION I I PERM7T EX7iflE0 PERMITCANCELLED PE 0hiT EXiENOED ` PERMIT FINAL CERTIFICA', E OF OCCUPANCYISSUEO DATE I By OF COMPLIANCE WITH CODE OF FEDERAL PART 61 OF TITLE 40 AND AOMD RULE NL;Sif3CiPi'f1L�Iw'IF3i!L�5!_II'1sL:I:i��iYii FOR OFFICE USE ONLY Civil Code).