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Home My WebLink AboutF2024-0134 - Permits"gWpoR, City of Newport Beach II II IIIIIIIIII IIIII IIIIII IIIII IIII IIIIIII III II COMB Permit : F2024-0134 0 4 ,d Q Community Development Department - Building Division F 2 9 2 4 - 9 1 3 4 H 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2024-0550 Permit Counter Phone: (949) 718-1888 Issued Date : 03/19/2024 newportbeachca.gov/civic Final Date: C4CIFp0.N�P 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: 620 NEWPORT CENTER DR, 100 Legal Desc : P BK 295 PG 33 PAR 1 PARCEL MAP 295-33 PAR 1 POR O Description: COMM FIRE ALARM SYSTEM 12 DEVICES "LUGANO WORKSHOP" (XC2024-0021) Owner: 620 NCD LLC Address : PO BOX 2450 NEWPORT BEACH, CA 92658 Phone Applicant: MIRIAM GOMEZ Address : 1354 S PARKSIDE PL ONTARIO, CA 91761 Phone: (909)957-5200 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 : 02/28/2026 Bus Lic : BT30042287 Bus Lic Expire : 02/28/2025 Workers' Compensation Insurance Carrier: FEDERAL INSURANCE COMPANY Policy No : 54309498 W. C. Expire: 3/2/2025 Code Edition : Fire Sprinklers : YES Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : No of Units : 1 Bldg Height: No of Stories : 1 Building Setbacks Flood Zone : X Use Zone: PC - North Newport Center 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 Construction Valuation : Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage : 0 TOTAL sq. ft. : 0 OWNER -BUILDER DECLARATION 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 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 he 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 Irofessens 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 lot more than five hundred dollars ($500), 1, as owner of the property, or my employees with wages as their sole compensation, will de (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiriess 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 mprovemsnts 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 mproved for the purpose of sale). 1, 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 oply 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). 1 am exempt from licensors under the Contractors' State License Low tar the following reasdn: _ 3y 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 :oll 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 tho Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site;http:fiwwvr:leginto.ca.gov/calaw.html. 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 7QQ ) f Di i 'a 3 of the Business and ProfessJJ'AA�� icense is In full farce Ind effect. License Class License No DaUl3„0� Contractor Signature //G� 5 VORKERS' COMPENSATION DECLARATION fARNING; FAILURE TO SECURE NIORKER5' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6t D0,000), IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEPS FEES hereby affirm under penalty of perjury one of the following declarations: -1 1 have Mind 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, e;formanco 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' ,rance 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 not employ any parson in any manner so as to become subject to the workers' compensation laws of California, and ogre, L if I should become subject to t e orkem, comvisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions, / nature of Applicant �,__ -_- Cate CLARATION REGARDIN 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 Cade). Apr's Name Lender's Address Ivy signature below, I certify to each of the following: I am the propeny 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 state laws relating to building construction. 1 authorize representatives of this city or county to on the Bove-ide Fif ed party for inspection purposes. I /rt� �/t /� �� /� (/q' �� /t� // /� nature of PrODeirtv Owner or Authorized Aaent 2- Print Pronartv Owner's nr Authori>ed Anant'c Name IV I 1 v 1✓ t! y t `ltiV� f,7 F.f. tJDIl"/lG4 ACTION ! DATE BY ( DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 3 PERM 7EXFIREO PERMIT CA...... C � SUBMITTED ASBESTOS NOTIFICATION TO IrA AERMiT EXCE+vDEO PEAMYT RNAL q_1 ASBE5Tp5 NOTIFICATION 15 NOTAPPLICABLE 10 , 8 Zh CERTfFtCATE OF CC 1' PROPOSED DEMOLITION OCCUPANCYISSUEO — _ SloNATURE: