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HomeMy WebLinkAboutF2023-0542 - Permits�EWPORT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : F2023-0542 pr' A Community Development Department- Building Division F 2 0 2 3 0 5 4 2 100 Civic Center Drive, NewportBeach, CA 92660 Plan Check No : PC2023-0495 Permit Counter Phone: (949) 718-1888 Issued Date : 11/0712023 newportbeachca.gov/civic Final Date: Cg4Fp0.N\P Combination Type - Permit Status: Issued Work Class - New 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 : 690 NEWPORT CENTER DR Legal Desc : P SK 196 PG 13 PAR 2 PARCEL MAP 196-13 PAR 2 FOR O Description: COMM FIRE ALARMS 13 ADD'L DEVICES Owner: 690 HOTEL LLC Address : 690 NEWPORT CENTER DR NEWPORT BEABH, CA 92660 Phone Applicant: ADT COMMERCIAL LLC Address: 210 W BAYWOOD AV ORANGE, CA 92765 Phone: (675)566-3065 Owner/Builder : Address : Phone Contractor: ADT COMMERCIAL LLC Address : 210 W BAYWOOD AV ORANGE, CA 92765 Phone: (675)566-3065 Con State Lie : 1065604 Lie Expire : 05/31/2024 Bus Lie : BT30072351 Bus Lie Expire : 07/31/2024 Workers' Compensation Insurance Carrier: OLD REPUBLIC INSURANCE Policy No : MWZY31801723 W. C. Expire : 10/1/2024 Code Edition : 2019 Fire Sprinklers : Type of Construction : V-B Fire Hazard Zone Occupancy Groups : No of Units : Bldg Height : No of Stories Building Setbacks : Flood Zone : X Use Zone : PC - North Newport Center PROCESSED BY: SPECIAL CONDITIONS: REV2023-2210 Architect Address Phone: State Lie Engineer Address Phone Designer: ACT COMMERCIAL LLC , Address: 210 W BAYWOOD AV ; ORANGE, CA 92765 - Phone: (675)566-3065 YES Construction Valuation : NO Added/New/TI sq. ft. Bldg 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage: TOTAL sq. ft. : $1,000.00 0 0 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason i indicated below by the checkmark(s) I have placed next to the applicable items) (Section 7C31.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, pnor 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 Low (Chapter 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 7091,5 by 6ny applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars i$500). CC ❑ I, 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 Contmctors' Slate 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 was not built or Improved for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to constructthe 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 %he contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law). 11 I am exempt from licensure under the Contractors' State License Law for the following reason By my signature below i acknowledge that, except for my persanat residence In which I must have resided for at least one year prior to earn pletion of the inn provemanis covered by thIs permit, I cannot Iagalll sell a structure that I have built as an owner -builder if ithas not been constructed in its entiroty 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:lhwnv.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 7000) of Division 3 of the B siness and Profession ,,aa� my license is In full force and effect. License Class License No / .3Aa`te I ) Z71 %5 Co- actor Signature / WORKERS' COMPENSATION DECLARATION NARNING: 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 1i100,000j, IN ADDITION TO THE CDST OF Cr MPENSP7"04, CCMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty, of perjury one of the following declarations: 7, 1 hone and will maintain a certificate of consent to self -insure for walkers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for Ih per€Trm: rice of th3 work 'it which this permit is issued. Policy No. and will mainlaln 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 dnt: policy number are: Ibf _ it, of Agent Policy Number Date I certify that, in Btc performance of the work for which this permit is Si I shall not employ any person in any manner so as to become subject to the L it I should bpsome subject to khe�v�ers' corDpe9aation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. CLARATION REGARDING CONSTRf7CTION LENDING AGENCY / areby 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( )dor'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 behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building. construction. I authorize representatives of this city or county to enter the above'id ed property for inspection purposes. A nature of Property Owner or Authorized AdiPil :����. Print Proeertv Owner's or Authorized AGentt`s,Name X19 ACTION I DATE � XBY 3 DECLARATION'. OF COMPLIANCE W17H CODE OF FEDERAL FOROEFICEUSEONLY �\ REGULATIONS PART' 6t OF TITLE 40 AND AQM0 RULE 14U3 rPERM1T EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERNHTFINAL 131jJa3 I IJYAVLt�/ U ASBESTOS NOTI PICA I ION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OGCUPANCYISSUED I SIGNATURE: compensation laws of California, and Dale I 1 I7/ Z , Civil Code).