HomeMy WebLinkAboutF2024-0033 - Permits�EWPO�T City of Newport Beach IIII IIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit F2024-0033
Community Development Department- Building Division F 2 9 2 4 0 0 3 3
F Fy 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2024-0123
T Permit Counter Phone: (949) 718-1888 Issued Date : 01/3112024
o-. newportbeachca.gov/civic Final Date:
C,�rF00.N`P Combination Type - Permit Status: Issued i
Work Class - New Inspection Area :,ji
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: 221 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 (22 DEVICES) *XC2023-0447*
Owner: IRVINE COMPANY
Address : 110 INNOVATION DRIVE
IRVINE, CA 92617
Phone : (949) 720-2000
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
Can State Lie :
469046
Lie Expire :
08/31/2025
Bus Lie :
BT30046473
Bus Lie Expire
: 03/31/2024
Workers' Compensation Insurance
Carrier: TRAVELERS PROPERTY CASUALTY CO OF
AMERICA
Policy No: UBOK0634482243G
W. C. Expire : 10/1/2024
Architect
Address
Phone:
State Lie
Engineer:
Address:'
Phone
Designer: INTERFACE SYSTEMS
Address: 3750 SCHAUFELE AV, 2CO3
LONG BEACH, CA 90808
Phone: (562)353-4680
Code Edition :
2022
Fire Sprinklers:
YES
Construction Valuation :
$8,000.00
Type of Construction :
III-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
No of Units :
1
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 - North Newport Center
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of pe€}ury that I ant exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkrnark(s) I have placed next to the applicable item(s)
3eclion 7031.5, Business slid 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
is 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
'rofessiuns Code) or that he or 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
of more than five hundred dollars ($500).
a 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 effort, builds or improves the property, provided that the
nprovemenls 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
nproved for the purpose of sale).
7 1, 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
ploy 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 I am exempt from licensors under the Contractors' $rate License Law For the following reason:
,y my signature below I 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, I cannot legally
ell a structure that I have built as an ownor-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
'rofessiuns Code, is available upon request when this application is submitted or at the following web site:http:/IwN .leginfo.ca.gov/calavahtml.
Ignature of Property Owner or Authorized Agent _. - Date/
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under renally of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Praf '10 s d .art® license i. In full force
nd effect. License Class License No Date (- 3/-2s+x. Contractor Signature
V0FHIeFRS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE le UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,0001, IN ADDrrION TO THE
OS" OF POMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3TO6 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hnreo,, affirm underpenalty of perjury one of the following declarations:
J I have and wi•I 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 IN
e.forn,ance of the work for which this permit is issued. Policy No.
nave 4nd will maintwo 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'
,annc carrier and policy number are:
Policy Number
of Agent
Date
: certify that, intf c performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject 10 the workers' compensation laws of California, and agree
t, it I should bewmn sn6ject to the workes' mpen for provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
mature of Aliplicant , Date
CLARAT€ON RFGA ING CONSTMUCTONN LEN It AGENCY
3reby 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 Cade).
Mer's Name Lenders 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 ordirlances and state laws relating to building construction.
I authorize representatives of this city or cou y to nt a !-identified property for inspection purposes. \ �,
mature of Prooerty Owner or Authorized Aaent rl ` Print Procertv Owner's or Authorized Acent's Nam?,---1 t t^ n rw t_ natr f -3t-z¢
PERMIT EXTENDED
PERMrT FIRAL
CERTIFICATE OF
OCCUPANCYf53UED
DATE. BY € DECLARAT€ON OF COMPLIANCE WITH CODE. OF FEDERAL FOR OFFICE USE ONLY
i REGULATIONS. PART 61 OF TITLE 40 AND AQNID RULE
NOT] PICA rnpN IS NOT APPLICABLE TO