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Home My WebLink Aboutf2022-0290 - Permits9City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIII�II�IIIIIIIIIIIIII'll II FIRE Permit: F2022-0290 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 2 9 0 Project No : 1464-2022 '4 `- s Permit Counter Phone (949)644-3288 eN r Inspection Requests Phone (949)644-3255 Job Address: 5000 BIRCH ST NB St: 1 Ft: 9 Unit: 9600 Description: COMM FIRE ALARMS 3 DEVICES (X2022-0427) Inspector Area: FIRE Legal Description: P BK 181 PG 13 PAR 5 LIFE INSCO or. FIRE SAFETY ST t Address: 3111 MICHELLSONDR#4O s Addres 1170 EFRUIT ST Address: NEWPORT BEACH, CA92612 SANTA ANA CA 92701 Phone: Phone: 714-836.4800 X137 Phone: State Lic: ® ° a Applicant: MENDOZA GABY Con State Lic: 599761 Engineer: Address: 1170 EFRUIT ST Lic Expire: 08/3112022 Address: SANTA ANA, CA 92701 Bus Lic: BT00009906 �co 0 Phone: 714-263-2871 Lic Exp Date: 06/30/2022 Phone: State Lic: Code Edit:2019 Workers Compensation Insurance Designer: MENDOZA GABY • Type of Construction: I-ASPR Carrier: BERKSHIRE Address: 1170 E FRUIT ST O3 °°° Occupancy Group: B Policy No: BRWC228919 SANTA ANA, CA 92701 Added/New sq.ft. Bldg: 0 Expire: 11/0112022 Phone: 714-263-2871 Added/New sq. ft. Garage: 0 No of Stories: 10 Issued Date: 06/07/2022 Special Conditions: No of Units : 0 Setback- Front: Flood Zane: Rear: Bldg Sprinklers: N Left: Right: FEES Construction Valuation: $1,000.00 Building PC Fee : $0.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $4.00 Building Overtime PC Fee: $0.00 Planning Counter Review: $0.00 Building Extention Fee : $0.00 Planning Zoning PC Fee : $0.00 Building Investigation Fee: $0.00 $0.00 Fire Plan Check Fee: $170.75 Public Works PC Fee: $0.00 $0.00 Fire Permit Fee : $242.75 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $0.00 TOTAL FEE : $417.50 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $417.50 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: �Q FIRE APPROVAL: APPROVALTO ISSUE: ( l PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -BUILDER DECLARATION 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 applicable item(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 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 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 not more than five hundred dollars ($500). 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 or 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 property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or improved 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 apply to an owngrofproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempwf licensure under the Contractors' State License Law for the following reason: ,ry%yignature gplpiw 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, ell a stucture-thdtJ J15ve 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 Rr'ofessions Code+is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. ierw&UTe of Property Owner or Authorized Agent Date LJCE14SED WATRACTOR'S DECLARATION hftepaffirm: fider p. natty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an Prof io s CoQe my license is in full force and effect. ticense.Class •. License No Dat �2Z Contractor Signatur •.••• WORKERS' COMPENSATION DECLARATION WARNINOt FAILURETO SIOURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES up TO ONE UNDRED THOUSAND OLLARS (S1O6,0001, IN ADDITION TO THE COST OFCOMPENSByQN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. t IM&n&Zaffirm ugderppalty of perjury one of the following declarations: "I h .• ave and vriN 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 performance 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: me of Agent I certify that, in the performance of the It. if I should become subiect to the wY Signature of Applica Policy Number Date 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 I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. _ _ DECLARATION REGVDINL- eCENSTRUCTION LEPYINGWGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is Lender's Name Lender's Address By 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 information I have provided is correct. I agree to comply with all applicable city and county or nance/� an sta WS relating to building construction. I authorize representatives of this city or county toe a f�refov - e Ifie property for inspection purposes. Signature of Property Owner or Authorized Agenp,% ,k -�(_ _ Q_ Print Property Owner's or Authorized Agent 3097, Civil Code). -TWlnk� 7- �Date6 - -- -22- ACTION DATE 1 BY - DECLARATION OF COMPLIANCE KgTH CODE OF FEDERAL REGULATIONSPART 61 OF TITLE40AMO AQMD RULE 1403. ❑ ISUBAfTFEDASBESTOS NORFICATION' TO:. ❑ EPA ❑ AQMD ❑ ASBESTOS NOFFICARONIS NOTAPPLICABL€TO PROPOSED DEMOLITION. SIGNATURE: FOR OFFICE USE ONLY PERMIT EXPIRED PERMIT CANCELLED PERMITEXT€NDED PERMIT FINAL T�L� CERTIFICATEOF OCCUPANCYISSUED