HomeMy WebLinkAboutF2023-0162 - PermitsCity of Newport Beach
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Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone. (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
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newponbeachca.gov/inspections
Combination Type -
Work Class - Tenant Improvement
COMB Permit: F2023-0162
Plan Check No : PC2023-0824
Issued Date : 04/12/2023
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 : 5000 BIRCH ST, 1ST FL RR Legal Dose : P BK 181 PG 13 PAR 5
Description: COMM FIRE SPRINKLER TI WITH 6 HEADS AT 1ST FL RESTROOM & CORRIDOR (XC2023-0032)
Owner: JOHN HANCOCK LIFE INSURANCE COMPANY
USA
Address :
865 S FIGUEROA ST STE3320
LOS ANGELES, CA 90017
Phone:
(949)757-0397
Applicant :
CARLOS LOPEZ
Address:
2961 MACARTHUR BLVD, 118
SANTA ANA, CA 92704
Phone:
(562)242-5130
Owner/Builder
Address :
Phone
Contractor: APEX FIRE SYSTEMS INC
Address : 2961 W MACARTHUR BLVD, 118
SANTA ANA, CA 92704
Phone:
(949)337-9679
Con State Lie
: 732396
Lie Expire :
09/30/2023
Bus Lie:
BT30006908
Bus Lie Expire : 01/31/2024
Workers' Compensation Insurance
Carrier: ACE AMERICAN INS CO
Policy No: C69981185
W. C. Expire: 11/1/2023
Architect
Address
Phone:
State Lie
Engineer:
Address
Phone:
Designer: APEX FIRE SYSTEMS INC
Address: 2961 W MACARTHUR BLVD, 118
SANTA ANA, CA 92704
Phone: (949)337-9679
Code Edition :
2022
Fire Sprinklers :
YES
Construction Valuation :
$1,000.00
Type of Construction :
I -A
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
B
No of Units :
1
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories :
11
Added/New sq. ft. Garage:
0
TOTAL sq. ft.
0
Building Setbacks
Flood Zone:
X
Use Zone :
PC - Koll Center
PROCESSED BY:
SPECIAL CONDITIONS:
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
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 licensors 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
of more than five hundred dollars ($500).
1, 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 70",
lusiness 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
nprovements 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' Stale License Law does not
�ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law).
I am exempt from Iicensure under the Contractors' State 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
ell a structure that I have 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 low, Section 70" of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:llw .leginfo.ca.gov/calaw.html.
Agnature 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 7000) of Division 3 of the Business and Professions Code, and my license is In full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
1ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND COWL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000), IN AuumON TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES.
hereby affirm under penalty of perjury one of the following declarations:
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 Ih,
erformance 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 carter and policy number are:
Policy Number
Agent
Date
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
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall rorlhwith comply with those provisions.
ignature of Applicant Date_ _
iECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby 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).
enders Name Lender's Address
y my signature below, 1 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 ordinances and stale laws relaling to building construction.
I authorize representatives of this city or county to enter the above -Identified property for Inspection purposes,
ignature of Property Owner or Authorized Agent — _. _. _ _ _ _ _ _ Print Property Owner's or Authorized Aoent's Name
BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
' ❑ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
_
UEPA
PERMIT EXTENDED
QMD
PERMIT FINAL
CERTIFICATEOF
OCCUPANCY ISSUED
,913
ICWIrtg
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE: