HomeMy WebLinkAboutF2024-0056 - Permits�gWPORr City of Newport Beach,...11111111111111111111111111111111111111111111111111111111111111Jill COMB Permit: F2024-0056
04 Community Development Depa mentE Buil sing ®ivsiai= F 2 0 2 a 0 0 5 s
100 Civic Center Drive, Newyork Beachy CA 926&0 < u ., Plan Check NO : PC2024-0213
G S Permit Counter Phone: (949) t1'8°188i Issued Date : 01/31/2024
newportbeachca.gov/civic Final Date:
�9tico aN�P Combination Type - Permit Status: Issued
Work Class - Other _ _ 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 : 100 BAYVIEW CIR, STE 6500 Legal Desc : N TR 12528 BLK LOT 2
Description: NEW COMM FIRE ALARM SYSTEM 10 DEVICES (XC2023-0404)
Owner: GPI BAYVIEW LLC
Address : 5601 GRANITE PKWY STE 7200
PLANO, TX 75024
Phone: (949)725-9900
Applicant:
H C I SYSTEMS INC
Address :
1354 S PARKSIDE PL
ONTARIO, CA 91761
Phone:
(909)628-7773
Owner/Builder
:
Address :
Phone :
Contractor: H C I SYSTEMS INC
Address : 1354 S PARKSIDE PL
ONTARIO, CA 91761
Phone:
(909)628-7773
Con State Lic
: 905493
Lic Expire :
02/29/2024
Bus Lic:
BT30042287
Bus Lic Expire : 02/29/2024
Workers' Compensation Insurance
Carrier: FEDERAL INSURANCE COMPANY
Policy No : 54309498
W. C. Expire : 3/2/2024
Code Edition : 2022
Fire Sprinklers :
Type of Construction : II-B
Fire Hazard Zone
Occupancy Groups : B
No of Units :
Bldg Height :
No of Stories
Building Setbacks :
Flood Zone : X
Use Zone : PC - Bayview
PROCESSED BY:
SPECIAL CONDITIONS:
Architect
Address
Phone :
State Lic
Engineer
Address
Phone
Designer: H C I SYSTEMS INC
Address : 1354 S PARKSIDE PL
ONTARIO, CA 91761
Phone: (909)628-7773
NO Construction Valuation :
NO Added/New/TI sq. ft. Bldg
1 Alteration sq. ft. Bldg :
1 Added/New sq. ft. Garage
TOTAL sq. ft. :
OWNER -BUILDER DECLARATION
t hereby affirm under penalty of perjury that I. am exempt from the Contractors' Slate License Law for the reason(s) TdiccteC beiw bl re &,ackm«rk(s) .'have placed next to the applicable liens
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct. Eller, improve, dernrli5 n, or r^p -Y E.ny stryclire, priLT to its issuance, also requires the applicant for
)c permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law lChaprer 9 (commencing with Section 7000) of Division 3 of the Business and
'rofessions 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 for a permit subjects the applicant to a civil penalty of
ut 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 U portions of the wcA, and the structure is ni intended or offered for sale (Section 7044,
lusiness and Professions Coda: The Contractors' State License Law does not apply to an owner of property who, through �mnloyr•es' or on-sor Tl effort, bolds it :,reproves the properly, provided that the
mprovements are not Intended or offered for sale. If, however, the building or Improvement is Sold within one year of completion th? OWrer-13wlder will hev the burden of proving that it was not built or
reproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to constructthe project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
poly 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 Law).
I I am exempt from Ilcensure under the Contractors' State License Law for the following reason: _______
py 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 entirety by licensed contractors. 1 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:llwwM1v.leginfo.ea,gov/calaw,html.
.ignature 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 70Q0) g D)' 'sign 3 of the Business and Pro Sion �CAde and nn yei se is to full force
nd effect. License Class License No Date l I-i I vl Contractor Signature • �'y L�"��-
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUaJEOT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS f$1D0,0001, IN ADDITION TO THE
OST OF COMPENSATION, pAMAOFS AS PROVIDED FOR IN SECTION a706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES -
hereby affirm under penalty of perjury one of the following declarations:
I 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, forth,
g[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:
Policy Number
of Agent
Date
certify that, in the performance of the work for which this permit is Issued. I shall notemploy any parson in any manner so as to become subject to the workers' compensation laws of California, and
if I should become subject in the workW' compensation orovlsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Date * 6 1 mI /Z`7
CLARATION REGARDING'CONSTRUCTION LENDING AGENCY �-
areby 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).
)der 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.
1 have read this application andthe information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to en1pr the�Agve-Idje;U lled property for inspection purposes.
Authorized
I
ACTION DATE. BY DECLARAT€ON. OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
RFGULATION5 PART 51 OFTITLF.40 ANDAQMD RULE
1403
PERMIT EXPIRED
PERMIT CANCELLED
PERMJ'T FINAL /( ('�( I-Lunali U ASBESTOS NOT IFICATION IS NOT APPLICABLE to
CERTIFCATE OF - PROPOSED DEMOLITION
OCCUPAPJCY15SUED SIGNATURE:
Date •