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HomeMy WebLinkAboutF2023-0190 - Permits�Ewvo�T City of Newport Beach II III IIII IIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIII IIIII IIIII IIIII IIII II COMB Permit F2023-0190 04 �. Community Development Department- Building Division n 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1002 m Permit Counter Phone: (949) 718-1888 Issued Date : 05/22/2023 .m newportbeachca.gov/civic Inspection Area : FIRE Cqf/FORN\P Combination Type - Work Class - Tenant Improvement PERMITS EXPIRE 160 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 AREA ed—ry R,S Job Address : 4675 MACARTHUR CT, STE 1400 Legal Desc : P BK 196. PG 40 PAR 3 N Description : COMM FIRE ALARM - 5 DEVICES (XC2023-0141) Owner: IRVINE COMPANY Contractor: SIMPSON DAVID CONST CO INC Architect :. Address : 110 INNOVATION DRIVE Address : 17177 GILLETTE AVE #A Address IRVINE, CA 92617 IRVINE, CA 92614 Phone : Phone : (949) 250-1348 Phone : n Con State Lic : 381149 State Lic : r� Lic Expire: 03/31/2025 Applicant: JUDY YAM Bus Lic: BT00006013 Engineer Address : 392 N LEMAY CT Bus Lic Expire : 06/30/2023 Address ORANGE, CA 92867 Phone: (626) 675-9882 Workers' Compensation Insurance Phone: Carrier: CYPRESS INSURANCE COMPANY Owner/Builder : Policy No: DAWC426822 Designer: BUILDING ELECTRONIC CONTROLS Address : W. C. Expire : 5/1/2024 Address: 2246 LINDSAY WAY GLENDORA, CA 91740 Phone: (909) 305-1600 Phone: Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : $1,475.00 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 Use Zone : PC - Koll Center PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION € hereby affirm under penalty 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 itemil (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 Rio 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 iicensure 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).. ❑ I, as owner of the property, or my employees with %Vegas 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, ilia 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). ❑ I, as owner of the properly, 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' State License Law for the following reason! ____ By my signature below !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, t canna[ lagalll sell a structure that I have built as an owner -builder if it has not been constructed in its entiroty by licensed contractors. I understand that a copy of the applicable taw, Section 7044 of the Business and Professions Code, is available upon request when this application is Submitted or at the following Web site:http:IANvw.leginfo.ca.gov/Calaw.html. Signature of Property Owner or Authorized Agent ate LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectionr��f the Business and Profe If ense is full force and effect. License Class License No Dat Contractor Signature NORKERS' COMPENSATION DECLARATION NABBING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND S (St00,000). IN ADDITION TO THE :OW OF COMPENSATION, DAMAGES AS PROVIDED FOR W SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one or the following declarations: -11 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, forth terformance of the work for which this permit is issued. Policy No. navy and will maintain workers' compensation insuranco, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior sure ca carrier and policy number are: Warrier Policy Number Expiration Date \lame of Agent Phone ib —11 certify that. in the performanc of t work for ch this pe d issued, I shall not employ any person in any manner so as to become SUD Ct to the workers' compensation laws of California, and ogra, hat, if I should becom subject th wo a ' co a , tion ro ions of Section 3700) of the Labor Code: I shall forthwith comply with those provisions. 3ignature of Applican Dat Z� )ECLARATfON REG, RDIN TR CTI DI A4 CV hereby affirm under penalty of perjury that there i struction ng agency for the performance of the work for which this permit is issued (Section 3097, Civ I Code). -enders Name Lender's Address. Ay 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 ha,re react thl„ apLlication and the information I have provided is riot. I agree to comply with all applicable city and Do my romances slate laws lating to building construction. I cuthorrae representatives of this city or county I ntar the a. a -id n hied party, for inspection purposes. Sjnatira o[ f3rC.pDYtLCwltar trr Authorized A eat Print PropertyOwner's or Authorized A ent's Nam �.-� gte ACTi,M DATE BY DECLARA rON OF COMPLIfiNCEWITH CODE OF FEDERAL FOR OFFICE USE ONLY RfELRATIONS PART 61 OF TITLE. 40 AND AQMD RULE 1403 PET'VT EXPfRED Of SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCEt'.Ep E FP� A I Edm,i EXTENDER _ � 4Ns0 f Crt.vrrT iiNAL .� �l �- �,1� �� �„J..ASBESTOS NOTIrICATION IS NOT APPLICABLE TO CE,RTIF(CAFE OF S POSED DEMOLITION OCCUPANCY ISSUED