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HomeMy WebLinkAboutF2023-0367 - PermitsaF WPoRr ' City of Newport Beach IIIII II II II I IIII I II IIIII IIIIIjlllll 11 II COMB Permit : F2023-0367 Community Development Department- Building Division F 2 0 2 3 0 3 6 7 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1869 Permit Counter Phone: (949) 718-1888 Issued Date : 08/0312023 aw r newportbeachca.gov/civic R°'S r �� 1^'� Final Date: " FoaN Combination Type - Work Class -Tenant Improvement 6 %—. 3 L—`" -% d t Permit Status: Issued P 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 LenxYV,,4c V J Job Address : 843 NEWPORT CENTER DR Legal Desc : P BK 221 PG 30 PAR 6 P.M. 221-30 PAR 6 FOR OF PAR Description: COMM FIRE ALARM TI WITH 40 DEVICES FOR "LENSCRAFTERS" (XC2023-0096) Owner: IRVINE CO Address : 111 INNOVATION IRVINE, CA 92618 Phone : (949) 720-3100 Applicant: RICHARD JOHNSON Address : 3750 SCHAUFELE AV, 200 LONG BEACH, CA 90808 Phone: (562)353-4680 Owner/Builder : Address : Phone Contractor: INTERFACE SYSTEMS Address: 3750 SCHAUFELE AV, 200 LONG BEACH, CA 90808 Phone: (562)353-4680 Con State Lic : 469046 Lic Expire : 08/31/2023 Bus Lic: BT30046473 Bus Lic Expire : 03/31/2024 Workers' Compensation Insurance Carrier: TRAVELERS PROPERTY CASUALTY CO OF AMERICA Policy No: UBOK0634482243G W. C. Expire : 10/1/2023 Architect Address Phone: State Lic Engineer: Address Phone Designer: INTERFACE SYSTEMS Address: 3750 SCHAUFELE AV, 200 LONG BEACH, CA 90808 Phone: (562)353-4680 Code Edition : 2022 Fire Sprinklers : YES Construction Valuation : Type of Construction : III-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg Occupancy Groups : M 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 North Newport Center PROCESSED BY: - R15 SPECIAL CONDITIONS: $12,000.00 0 0 0 OWNER -BUILDER DECLARATION - T I 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 items) (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 file 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 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). ❑ I, is owner of the property, or my employees with wages as their sole compensation, will do f-) all of or (_) 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 amployeess' 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 yearof 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 property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not a ply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors Stale License Law). I and exempt from licensors under the Contractors' State License Law for the following reason _ __—"."...._ ...__._"—.. By my signature below I acknowledge that. except for my personal residence in which I nTusL have resided for at least one year prior to completion of the Rnprovemenls covered by this permit 1 cannot legally sell a structure that I have built as an owner -builder If it has not been constructed in its entirely 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:hwww.leginfo.ca.gov/calaw.html. Signature, of Property Owner or Authorized Agent ._.-_. .... Data 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 Business and ProfessioC d fl my license is in full force and effect. License Class License No Date- 3 Z'Ai Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS t5100,0e01, IN ABOITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 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 370G of the Labor Code, for IN performance of the work For which this permit is issued. Policy No. 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' carrier and policy number are: of Agent certify that, in the performance , If I should'. become -subject to nature of Policy Number Date 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 co en -tion provisions of Section 3700 of the Labor Code. I shall forthwith comply with those provisions. CLARATION REGARDINGFCONSTRUCTIO ENDING AGENCY sreby 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 rder's Name Lender's Address my signature below. I certify to each of the following: 1 am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I Aprov,Is correct.I agree to cor plti .eth all applicable city and couand se laws relating to building construction. I authorize refr i. cn atives of this city or county to�i led property for inspection purposes, rs'c-c of PrOD,_n1 Owner or Authorized Aoenl _-___ Print Property Owner's or Authorized Agent's Name IC _ ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL RFGULATIONS PART 6➢ OF TITLE 40 AND AQMD RULE 1403 R4R.rd!'L' E YPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCEL LCO CPA PERMIT E.ITENDCO �-1 PERMIT FINAL d1 �l�(�Y�S ! ASBESTOS NOI IFICAT'ION 15 NOT APPLICABLE 10 CSR FIC1.7EOF I (. PROPOSED DEMOLITION OCCUPANCY(SSUEC `, SIGNATURE: FOR OFFICE USE ONLY Civil Code). -3- 2