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Home My WebLink AboutF2022-0569 - PermitsatiWPoRr City of Newport Beach Community Development IIIII IIIIIIII IIIIII III IIIIIIIII IIII II�IIIIIIIII II COMB Permit F2022-0569 Department -Building Division F 2 0 2 2 0 5 6 9 : �. 100 Civic Center Drive, Newport Beach, CA 92660 - - Plan Check No : PC2022-2766 U > i Permit Counter Phone: (949) 644-3288 Issued Date: Inspection Requests Phone: (949) 644-3255 C'<IFe AN�P newportbeachca.gov/inspections Inspection Area : FIRE 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 Job Address: 1301 DOVE ST, STE 820 Legal Desc : P BK 120 PG 27PAR 1 Description: COMM FIRE ALARM TI (XC2022-1995) 2 DEVICES Owner: 1301 DOVE OWNER LLC Contractor: H C ISYSTEMSINC Architect: Address : 2101 ROSECRANS AVE STE3270 Address`i 1354 S PARKS] DE PL +.Address EL SEGUNDO, CA 90245 - ONTARIO, CA 91761 Phone: Phone: (909) 6287773 Phone: Con State Lie: 905493 State Lie ' Lie Expire : 02/29/2024 Applicant: H C I SYSTEMS INC Bus Lie: BT30042287 Engineer: Address : 1354 S PARKSIDE PL Bus Lie Expire: 02/28/2023 Address ONTARIO, CA 91761 Phone: (909) 628-7773 Workers' Compensation Insurance Phone: Carrier: FEDERAL INSURANCE COMPANY Owner/Builder : Policy No: 54309498 Designer: — "" Address : �W. C.Expire: 3/2/2023 Address Sa Phone: - - Phone: Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : $1,215.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : No of Units : . 0 :- Alteration sq. ft. Bldg : Bldg Height: No of Stories : ` 10 Added/New sq. ft. Garage: 0 TOTAL sq. ft. Bldg : 0 Building Setbacks Flood Zone : X - Use Zone : PC - Newport Place PROCESSED BY: ® a SPECIAL CONDITIONS: JJ I hereby affirm under penalty of perjury that tam exempt from the Connector$! state License Law for the reason(s) indicated below by the checkmark(s) I I,..as owner of the property, or my employees with %Vegas as merr sons compenseuen, WIUI uu j l au uI ui riness 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 theproperty, provided that the irovements 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 Proved for the purpose of sale). I:, se owner of the property,: am exclusively contracting with licensed Contractors to construct the project (Section 70", Business and: Professions Code: The Contractors' State License Law does not Ply 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 am exempt from licensors under the Contractors' state License Law for the following reason: my signature below I ocknowtedge that, except for my personal residence in which I must have resided for at least oneyear prior to completion of the improvements covered by this permit, I cannot let - ,. .. .. . __ , (c_.- __..,,..+,w..::..,.a:,..,hc; I— O.uninn 9nAA of ihn Gluninncc and I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing vdth section 7.000)o_f Division 3,of the Business and Professions C rise is in lull torce. and effect. License Class License No Date 12-I(_ Contractor Signature 1V WORIKERS' COMPENSATION DECLARATION MARRING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN. EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ISi00A00j IN AUDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION?71t0 OF THE LABOR CODS INTEREST, AND ATTORNEY'S FEES: II hereby affirm under penalty of perjury one of the following declarations: 1,+1Y1 have and VIM maintain a-cerifficate of consent to.solf-insure for workers' compensation, issued by: the Director of Industrial Relations as provided for by Section 3700 of the Labor Code; for th Kr9ormance of the work for which this permit is issued. Policy No: have and will maintain worker' compensation insurance, as required by section 37GO of the Labor Code, for the performance of the work for which this, permit is issued. My. workers' compensation msu ance carrier and policy number am er Policy Number Expiration Date ., _.k.- ..__Phone :# certify that, in the performance of the work for which this , If I shouid become subject to the workes'�ergat I.am the pi I have rest Iagree to I l authorize ISSUED In in any mannerso as to become subject to the workers' compensation laws of California, and agree is, I shall forthwith :comply with those provisions. j oatE-A 1 ZZ the. work for which- this permit Is: issued (Section 3097,. Cavil Code), laws relating to building construction. ad property for inspection purposes_ TO Neyl > > > s ee• •� .• • e• . � s s ee> >c•