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Home My WebLink AboutF2024-0133 - Permits�Egra0", City of Newport Beach COMB Permit: F2024-0133 IIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIII�IIIIIIIIIIIIIIIIIIIII III D�- Community Development Department- Building Division F 2 0 2 4 0 1 3 3 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2024-0537 > ,= Permit Counter Phone: (949) 7I8-1888 Issued Date : 03I18/2024 m newportbeachca.gov/civic Final Date: o 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: 3501 JAMBOREE RD, 1250 Legal Desc : N TR 12528 BILK LOT 3 Description : COMM FIRE SPRINKLER SYSTEM 27 HEADS (XC2023-0472) Owner: SK HART BAYVIEW LLC Address : PO BOX 11623 SALT LAKE CITY, UT 84147 Phone: (949)823-9330 Applicant: A & D FIRE Address : 7130 CONVOY CT SAN DIEGO, CA 92111 Phone : (858) 277-3473 Owner/Builder : Address: Phone: Code Edition : 2o'L2— Type of Construction : I -A Occupancy Groups: Bldg Height: Building Setbacks : Flood Zone : X Use Zone : PC - Bayview PROCESSED BY: ,,.dl 4P W SPECIAL CONDITIONS: Contractor: A & D FIRE Address : 7130 CONVOY CT SAN DIEGO, CA 92111 Phone: (858)277-3473 Con State Lic : 1069002 Lic Expire : 09/30/2024 Bus Lic: BT30073130 Bus Lic Expire : 10131/2024 Workers' Compensation Insurance Carrier: SAFETY NATIONAL CASUALTY CORPORATION Policy No: LDC4068447 W. C. Expire : 9/16/2024 Fire Sprinklers : YES Fire Hazard Zone : NO No of Units : 1 No of Stories : 1 Architect Address Phone: State Lic Engineer: Address Phone Designer: A & D FIRE Address: 7130 CONVOY CT SAN DIEGO, CA 92111 Phone: (858)277-3473 Construction Valuation : 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' State License Late forthe reason(s) Indicated below by the chackmark(s) I have placed next to the applicable Items) iectlon 7031.5, Business And Professions Code: Any city or countythat requires aperrnit to construct. alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicamfor io permit to File a signed statement that he or she Is liconsed pursuant: to theprovisionsof 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 foensure and the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applioant to a civil penalty Of nt more than Five hundred dollars ($500).. 1 I, as owner of the property, or my employees with wages as their sole Compensation will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness and Professions Code: The Contractors State License Law does not apply to an owner of property who, through employees' or personal afforp 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 wili have the burden of proving that it was not built or nprovod for the purpose of sale). 11, 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 poly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuantto the Contractors State License Law), I I am exempt from licensure under the Contractors' Stale License Law for the following reason: _._... _ _ __ ___ _ -- ymy signature below I acknowledge that, except for my porsonal residence in which I must have resided for at least one year prior to completion of the improvements covered by this. permit, I cannot iegall} oil a structure that I have built as an oweor-buildar if it has not been constructed in its entirety by licensed contractors. I undorstand that copy of the applicable law, Section 7044 of the Businass and rofessions Code, is available upon request when this application is submitted or at the following Web site:http ilww w.leginfo.ca.goNAcalaw:htMI. Ignature of Property Owner or AuthOn7ed Agent _ _ _ _ Oates__ .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury Ihai I am ildensed under provisions of Chapter 9 (commancing with 5eclion 70Q0 of Division 3'ofthe Business and Professions Code, a�Wi my license is to full force nd effect License Class License No ,Date % Contractor Signature JORKERS' COMPENSATION DECLARATION EARNING: FArLURE TO SECURE WORKERS' COMPENSATION COVERAGE 19 UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (SID0,1XIOL IN ADDITION TO THE OST OF ocIvPEH9AT10Nt DAMAGES As PFOvinED FOR iN sEOTION 1106 OF THE LABOR CODE, VNTEREST, AND ATTORNE)nS FEES. hereby affirm under penalty of perjury one of the Following declarations: I have and will maintain a cartificate of consent to self -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Seddon 3,700 of the Labor Cods, for fir erformance of the work for which this permit is issued. Policy No. have and Willmaintainworkers' compensation insurance, as required by Section 3700 of the Labor Code, for theperformance of the work for which this permitis issued. My workers' nompensatioi isurance carrier and policy number are: :ardor Policy Number Expiration Date ame of Agent I certify that. inthe performance of thework 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. Caiffomia., and ogre iat, If I should became subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignalure of Applicant __ _..__._— Dale„_ ECLARAT€ON REGARDING CONSTRUCTION LENDING AGENCY hereby affirm under penallyof perjurythatthere is a construction lending agency forthe performance ofthe workforwhich this permit is issued (Section 3097,. Civil Code). enders Name. _ Lender'sAddress y my signature below, I certify to each of the. followings 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 �r7 {�, I agree to comply with all applicable city and county ordinances and slate laws relating to building construction. fU Y �� L'r') A�"'"Uvldl-,-7 I authorize representatives of this city or county toenterthe above-1 entlfled property for inspection purposes. — _. �.,..._»., r,...,.a.... A ,Ei,,,.,.�a Ana„r � — � - Print Prooertv Owner's or Authorized Agent's Name � � pate PERMIT EXPIRFL PEA it i7T CAM1' CEC C'� D PER;WT EXTENV ED PCR•AA17FINAL CERT(F/CATS OF OCCUPANCYISSUEJ DATE By DECLARATION OF COMPLIANCE WiT11 COOE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE 3. SEMS NO WICAT€ON IS NOT APPLICABLE TO .PROPOSED DFMOLIT€ON SIGNALUREc