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Home My WebLink AboutF2024-0095 - Permits,EwpoRT City of Newport Beach IIIIIIIIIIIIIIIIIIIII�IIIIIII II COMB Permit: F2024-0095 `� pm Community Development Department- Building Division F 2 0 2 4 e e 9 5 f > 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2024-0359 Permit Counter Phone: (949) 718-1888 Issued Date : 0212112024 u c r s newportbeachca.gov/civic a _ -, Final Date: Combination Type - Permit Status: Issued Work Class - Tenant Improvement 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 ALARM TI WITH 20 DEVICES (XC2023-0415) Owner: OCEAN WEST, WEST CAPITOL PARTNERS Contractor: H C I SYSTEMS INC Architect: Address: 2101 ROSECRANS AVE STE3270 Address : 1354 S PARKSIDE PL Address EL SEGUNDO, CA 90245 ONTARIO, CA 91761 Phone: (213) 326-4539 Phone : (909) 628-7773 Phone Con State Lic : 905493 State Lic Lic Expire : 02/29/2024 Applicant : MIRIAM GOMEZ Bus Lic: BT30042287 Engineer Address : 1354 S PARKSIDE PL Bus Lic Expire : 02/28/2024 Address ONTARIO, CA 91761 Phone: (909) 957-5200 Workers' Compensation Insurance Phone: Carrier: FEDERAL INSURANCE COMPANY Owner/Builder: Policy No : 54309498 Designer: H C I SYSTEMS INC Address : W. C. Expire: 3/2/2024 Address : 1354 S PARKSIDE PL ONTARIO, CA 91761 Phone: Phone: (909)628-7773 Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $2,000.00 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 : 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone : PC - Newport Place PROCESSED BY: ' SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reaeon(s) indicated below by the checkmark(s) I have placednext to the applicable items) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to constcucl, alter, improve, demolish, or repair any structure, prior toits issuance, also requires the applicant for the permit to file a signed statement that he or sheds licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (Commencing with Section 7030) of Division 3 of the Business and Professions Code) or that he at 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 not more than five hundred dollars ($500). 1 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Coda: 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 wasnot built or i improved for the purpose of sale). I ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct (he project (Section 7044, Business and Professions Code: The Contractors' State License Law does not III 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). u P projects P ) I ❑ 1 am exempt from Iicensure under the Conlractors' State License Law for the following reason By my signature below I acknowledge that, except for my personal residence In which I must have rosldad for at least one year prior to completion of the Improvements covered by this permit I cannot legally, sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. l 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://www,leginfo.ca,gov/calaw.html. Signature of Property Owner or Authorized Agent _ Date LICENSED CONTRACTOR'S DECLARATION iI hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with. Section 70 0 Slf,Ol I 'pp 3 of the Business and Professi Comma, end nse is in full force and effect. License Class License No Dat GI N Contractor Signature /C WORKERS' COMPENSATION DECLARATION. s WARNING: FAILURE TO SECURE 1VORRERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS i5100,000b eN ADDITION TO THE'. COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I 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 the performance of the work for which this permit is issued. Policy' No, r6i 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' compensation insurance carrier and policy number are: Policy Number of 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, end agree if I should become subject to the 'ry a/nsc�pmpensahon isions of Section 3700 of the Labor Code. I shall forthwith comply with those provisions. nature of Applrcent �,t/� _ _ Date CJ I0y �I AOAnnu oornoiSinlr r�iueronrn nM i-cuniur er_Fury �� 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). tinder's Name Lender's Address y my signature below, I certify to each of the following: I.am the properly "net 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 apnlleaAle city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter th�'fLove -id ntified _rope or inspection purposes. ' n �/�� anature of Proeerty Ov'ner or P.ulho:ized Anent % / Print Property Owner's or Authorized Agent's Name _li/ l'y o x' 1_ Go ACTION �.--- D%TE BY DECLARATION OF COMPLIANCE WITH CODEOF FEDERAL I REGULATIONS PART 52 OF TITLE 40 AND AQMD RULE 1403 FOR OFFICE USE ONLY I PERivi1T EXPIRED ISUBMIrFD ASRF$TOS NOTIFICATION TO PERMIT CAR'QLLE�. .. � '. EPA PERMIT EXTENDED PCPoIAIT FlNA! r- �j/Or�� -AQMD _ FJ(,((�iZ�L�+�AyaE5tO5 NUTIFICAIIUN IS NOT AVVUCABt.E TO CERTIFICATE Of p[p j PROPOSED DEMOLITION OCCOPANCYUSLIKI I j SIGNATURE: