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F2024-0074 - Permits
City of Newport Beach kaEvuPoR� 1 d Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 o- newportbeachca.gov/civic c9Uppry��P Combination Type - Work Class - Other Il 11 l llll llll lu 111 llllll l0lll7llll4 II ._ .ter u t COMB Permit : F2024-0074 Plan Check No: PC2024-0283 Issued Date : 02/14/2024 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: 1301 DOVE ST, 6TH FL Legal Desc : P BK 120 PG 27 PAR 1 Description : COMM FIRE SPRINKLER 51 HEADS (XC2023-0415) Owner: OCEAN WEST, WEST CAPITOL PARTNERS Address: 2101 ROSECRANS AVE STE3270 EL SEGUNDO, CA 90245 Phone: (213)326-4539 Applicant: CODE 4 FIRE INC Address : 187 W ORANGETHORPE AVE #O PLACENTIA, CA 92870 Phone: (714)231-9782 Owner/Builder : Address : Phone Contractor: CODE 4 FIRE INC Address : 187 W ORANGETHORPE AVE #0 PLACENTIA, CA 92870 Phone: (714)231-9782 Con State Lie : 905117 Lie Expire : 10/31/2025 Bus Lie : BT30083612 Bus Lie Expire : 02/28/2025 Workers' Compensation Insurance Carrier: PALOMAR SPECIALTY INS Policy No: PSIC1138603 W. C. Expire: 6/16/2024 Architect Address Phone : State Lie Engineer: Address Phone Designer: CODE 4 FIRE INC Address: 187 W ORANGETHORPE AVE #0 PLACENTIA, CA 92870 Phone: (714)231-9782 Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : Type of Construction : I -A Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : B No of Units : 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 1 Added/New sq. ft. Garage: TOTAL sq. ft. : Building Setbacks : Flood Zone : X Use Zone: PC - Newport Place PROCESSED BY: 505 SPECIAL CONDITIONS: $5,100.00 0 0 0 OWNER -BUILDER DECLARATION I hereby affirm under penally 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 items) (SOCII01 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 previsions of the Contractors' State License Law (Chaptor 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). 111. 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 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 withinone year of completion, the Owner -Builder will have the burden of proving that it was not built or Improved for the purpose of safe). © 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I❑ I a n 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 (oral least one year prior to completion of the' improvements covered by this permit, I cannot legail; sell a strUCtu€e 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 Cade, Is available upon requestwhen this application is submitted or at the following Web site:http:fmww.teginfo.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 7�0 Ioi I ` ' n 3 of the Business and Professions Did la cane is In full force and effect. License Class License No Date �L Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED T SAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY-3 FEES. l hereby affirm dnder penalty of perjury one of the following declarations: to 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 of the work for which this permit is issued. Policy No, and will maintain workers' compensation insurance, as required by Section 370D 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 of Agent Date ❑1 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 agre that. if I should become subject to the wor rs' compensation sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant ___ Dale�2 IZLi DECLARATION REGARDING C RUCTION LENDING AGENCY I hereby affirm under penalty of duty that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Cod ). Lenders 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 1 have provided is correct,. I agree to ccmply With all applicable city and county ordinances and state laws rotating to building construction. I authorize representatives of this city or county to ente�ritlhe ahpwe-identified property for inspection purposes. n _ / Signature of Prope.t/ C.,rner or Authorized Agent v/ // Print Pro erl Owner's or Authorized Agent's Name// o��/,�� Date P71ON DATE BY D- TION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY L GULATIONS PART 61 OF TITLE 40AND AQMD RULE SUBMITTED A58ESTOS NOTIFICATION TO !'f4V7FWAL �� 11 IS+Lur[.✓Nj UASBESTOS NOT] FICAI'ION IS NOT APPLICABLE TO T-FRTIFICATE OF PROPOSED DEMOLITION QrCUPANCY ISSUED SIGNATURE: