HomeMy WebLinkAboutF2023-0256 - PermitsCity of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� COMB Permit : F2023-0256
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Community Development Department- Building Division F 2 0 2 3 0 2 5 6
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1349
Permit Counter Phone: (949) 71 B-1888 Issued Date : 06/05/2023
newponbeachca.gov/civic Inspection Area : FIRE
CpdCombination 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
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Job Address : 4340 VON KARMAN AVE, 150 Legal Desc : P BK 387 PG 20 PAR 1 UN HOLD PARCEL 1 OF PARCEL MAP 387-20; HOLD PARCEL FOR
Description: COMM FIRE SPRINKLER RELOCATE 14 HEADS (XC2023-0010)
Owner: PATRICK LEE
Address : 4340 VON KARMAN AVE STE100
NEWPORT BEACH, CA 92660
Phone
Applicant: PACIFIC FIRE SUPPRESSION INC
Address: 249 E EMERSON #G
ORANGE, CA 92865
Phone: (714)283-0211
Owner/Builder :
Address :
Phone
Contractor:
PACIFIC FIRE SUPPRESSION INC
Address :
249 E EMERSON #G
ORANGE, CA 92865
Phone:
(714)283-0211
Con State Lie
: 423418
Lie Expire :
11/30/2023
Bus Lie:
BT03042109
Bus Lie Expire : 03/31/2024
Workers' Compensation Insurance
Carrier: EVEREST NATIONAL
Policy No: 5300004928211
W. C. Expire : 9/17/2023
Architect
Address
Phone :
State Lie
Engineer:
Address
Phone
Designer: PACIFIC FIRE SUPPRESSION INC
Address : 249 E EMERSON #G
ORANGE, CA 92865
Phone: (714)283-0211
Code Edition :
2022
Fire Sprinklers :
YES
Construction Valuation :
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/Ti sq. ft. Bldg
Occupancy Groups :
B
No of Units :
1
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
4
Added/New sq. ft. Garage:
TOTAL sq. ft.
Building Setbacks
Flood Zone :
X
Use Zone :
PC - Koll Center
PROCESSED BY:
$4,800.00
0
0
0
SPECIAL CONDITIONS: �'
I hereby affirm under penalty 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 applicableitem(s)
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
is 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
-rofessions Code) or that he or she is exempt from libensure 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
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 L) all of or L) portions of the work, and the structure Is not intended or offered for sale (Section 7044,
Iuseness 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
nprovemenls 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
n roved 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 properly who builds or Improves thereon, 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' Stale License Law for the following reason'
ly 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
all a structure that I have built as an owner -builder if it has not boon constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, isavailable 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
ACENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury, that I am licensed under provisions of Chapter 9 (commencing with Section 7 00 f sion 3 of The Business and P , and f y license is In full force
nd effect. License Class License No Date 12 Contractor Signatu
VORKERS' COMPENSATION DECLARATION
WINING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 19 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREPYsOUSAND DOLLARS (6100,000), IN ADDITION TO THE
OST OF COMPENSATION, RAMAOFS AS PROVIDED FOR IN SECTION 3795 OF THE LABOR CODE, INTEREST, AND ATTORNE'Ys FEES.
hereby affirm under penalty of perjury one of the following declarations:
J 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, for th
erformance of the work for which this permit is issued. Policy No.
�111an 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' compensation
r\urance carrier and policy number are:
.arrler Policy Number Expiration Date
lame of Agent Phone #
3 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
rat, if I should becom bject to th kegs compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �w
signature of APpiicant�T. Date Yl/a
rreby affirm under peVtyrof perjury that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Were Name Lender's Address
any signature belnw, 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 agrea to cotuply with all applicable city and county ordinances and state la relat g building construction.
I aut` orize representatives of this city or county t(AggWAhe abpve-(dpn}�I or inspection purposes.
DATE BY DECLARATION OF COMPLI,
REGULATIONS PART 61 OF
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OCCUPANCY ISSUED SIGNATURE
FOR OFFICE USE ONLY