HomeMy WebLinkAboutF2023-0397 - Permitsrc��WPo�r City of Newport Beach
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Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
u newportbeachca.gov/civic
c9oaN�P Combination Type -
Work Class - Tenant Improvement
11IIIIII111111111111111111111111111111111111111111111111111111 jj COMB Permit : F2023-0397
Plan Check No : PC2023-2062
Issued Date : 09/20/2023
-- ? Final Date:
Permit Status: Issued
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: 4675 MACARTHUR CT, 500 Legal Desc : P BK 196 PG 40 PAR 3
Description: COMM FIRE ALARM TI WITH 8 DEVICES (XC2023-0330)
Owner: IRVINE COMPANY
Address : 110 INNOVATION DRIVE
IRVINE, CA 92617
Phone: (949)720-2000
Applicant: MARK YAM
Address : 392 N N LEMAY CT
ORANGE, CA 92867
Phone : (626) 757-2320
Owner/Builder :
Address :
Phone
Contractor:
SIMPSON DAVID CONST CO INC
Address :
17177 GILLETTE AVE #A
IRVINE, CA 92614
Phone:
(949)250-134B
Con State Lie
: 381149
Lie Expire :
03/31/2025
Bus Lie :
BT00006013
Bus Lie Expire : 06/30/2024
Workers' Compensation Insurance
Carrier: CYPRESS INSURANCE COMPANY
Policy No: DAWC426822
W. C. Expire : 5/1/2024
Architect
Address
Phone:
State Lie
Engineer:
Address
:12T7ii-'
Designer: BUILDING ELECTRONIC CONTROLS
Address: 2246 LINDSAY WAY
GLENDORA, CA 91740
Phone : (909) 305-1600
Code Edition :
2022
Fire Sprinklers :
YES
Construction Valuation : $5,337.00
Type of Construction :
I -A
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups :
B
No of Units :
0
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories :
15
Added/New sq. ft. Garage: 0
TOTAL sq. ft. 0
Building Setbacks
Flood Zone :
X
Use Zone :
PC -
KDII Center
PROCESSED BY:
1
SPECIAL CONDITIONS:
,
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 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 fora permit subjects the applicant to a civil penalty of
net more than five hundred dollars (S500).
0 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is notintended 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 -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
1, 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 owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ I am exempt from Bcensure under the Contractors' State License Law for the following reason:
By 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
sill a structure that 1 have built as an ownor-builder if it has not been constructed in its entirety by hcensod contractors. I understand that a copy of the applicable law, Section 7044 of the Businoss and
Professions Code, is available upon request when this application is submitted or at the following Web site:http:tlw .feginfo.ca.gov'calaw.html.
Signature of Property Owner or Authorized Agent ...............__.___._...__.._..._.____.._„__�_..�_�___u._ Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under previsions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cad and my license is in full force
and effect. License Class License No Date �T; Contractor Signature'Z.�,
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WOR%ERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 9N SECTION 3706 OF THE LABOR COnE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the fallowing dectaratlorI
❑ I have and will maintain a certificate of consent to sell -insure [of Workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for lh
perfyFinance 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
-I certify that, in the performance of the work for which thispermit 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
fat, if I should become subject to the orkers' Compensation provisions of Section 3700 of the Labor Code, Ishall forthwith comply with those provisions.
signature of Applicant _ _._ __,_ __, _ Date F/z-&I
IECL.ARATION REGARDING CONST UCTION LENiSING 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 Cade).
enders Name Lenders Address
N my signature below, I certify to each of the following:
I am the property owner orauthorized 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 Paws relating to building construction.
1 authorize representatives of this city or county to enter the apove-identified property for inspection purposes.
e of Property Owner or Authorized Agent` ll'�/� Print Property
i DATE. j BY c DECLARATPON OF COMPLIANCE WITH CODE OF FEDERAL
RFGULATIONS PART fit OF TITLE 40 AND AOMD RULE
1403
EXPIRED , ( I SUBMITTED ASBESTOS NOTIFICATION TO
PrERMITEXTENDED j
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PE7FINAL I�3-''I J-j
rz'&;N;K Ir-JASBESTOS NOTIFICAIION 15 N01 APPLICABLE TO
CERTt`ICATE OF
PROPOSED DEMOLITION
OCCUPANCY ISSUED i
I I SIGNATURE:
FOR OFFICE USE ONLY
Name
Date