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Home My WebLink AboutF2023-0540 - Permits"C;poRp City of NewNart Baaca II II II I II I III III II III I II II II COMB Permit: F2023-0540 C`',.d. Community Development DeparLnen: Cui'fng Civi^.ion F 2 0 2 3 0 5 4 0 > y 100 Civic Center Drire, Ne"port Pea^.h, CP 9266) Plan Check No : PC2023-2677 n Permit Counter Phone: (949) 71b-1886 Issued Date : 11/01/2023 V S newportbeachca.gov/civic Final Date: C1</FOAN�r Combination Type - Permit Status: Issued Work Class - Othel 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 (EAST TOWER), UNIT 405 Legal Desc : P BK 181 PG 13 PAR 5 Description: COMM FIRE SPRINKLER SYSTEM TI WITH 23 HEADS (XC2023-0250) Owner: JOHN HANCOCK LIFE INSURANCE COMPANY USA Address : 865 S FIGUEROA ST STE3320 LOS ANGELES, CA 90017 Phone: (949)757-0397 Applicant: FIRE SAFETY FIRST Address : 1170 E FRUIT ST SANTA ANA, CA 92701 Phone : (714) 836-4800 x137 Owner/Builder : Address : Phone: Contractor: FIRE SAFETY FIRST Address : 1170 E FRUIT ST SANTA ANA, CA 92701 Phone: (714) 836-4800 x137 Con State Lic : 599761 Lic Expire : 08/31/2024 Bus Lic: BT00009906 Bus Lic Expire: 06/30/2024 Workers' Compensation Insurance Carrier: REPUBLIC INDEMNITY COMPANY OF AMERICA Policy No : 2569801 W. C. Expire: 11/1/2024 Code Edition : 2022 Fire Sprinklers : YES Type of Construction : I -A Fire Hazard Zone : NO Occupancy Groups : B No of Units : 1 Bldg Height : No of Stories : 10 Building Setbacks : Flood Zone : X Use Zone: PC - Koll Center PROCESSED BY: � — SPECIAL CONDITIONS: Architect Address Phone : State Lic Engineer: Address Phone: Designer: FIRE SAFETY FIRST Address : 1170 E FRUIT ST SANTA ANA, CA 92701 Phone : (714) 836-4800 x137 Construction Valuation : $5,600.00 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' Stale License Law for the reason(s) indicated below 7y'he chackrr~ have placgd next to the applicable items) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any s'rurtura, 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 d (commencing with Section 7060) 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 (S500). - ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or t_) portions of the work, and the stricture i. ioL intended Urefil 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 effo-t, brildc 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 -RI lilder wO have the bu,can c� 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 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 licensure under the Contractors' Slate 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 legal!, sell 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 law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http:llwww.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) of Division 3 of the Business and Professio d y ce se is h II force and effect. License Class License No Da Z Contractor Signature WORKERS' COMPENSATION DECLARATION NANNING: 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 t51 . 00), IN ADORION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 711 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 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: Policy Number Date no of Agent Phone 1i certify that, in the pertormance th we r ich this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre 1, if I should become s��utbjj��ect t th w rk co ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions, a nature of Applicant ,lv_ Data CLARATION REGARdING CONSTRUCT LE G AGENCY :reby 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). mer's Name Lender s Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's benalf. I have read this application and the information I have provided is correct, I agree to comply with all applicable city and county O 'nnc> es,r7.Al state laws relating to building construction I authorize representatives of this city or county to li t la((�/��y/�/dentified property for inspection purposes. r ,, PP nature of Prooertv Owner or Authorized Agent r1. Print Property Owner's or Authorized Agent's Name f�l Q.(, V G �V __ _ Date ` PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED DATE I BY IF DECLARATION41' COMPLIANCE WITH CODEOF FEDERAL i FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 ANCJ AOMD Rl1LE NOTIFICATION TO PERMIT FINAL �6 'J is � "Li l \ UASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF > PROPOSED DEMOLITION OCCUPANCY ISSUED - SIGNATURE: