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HomeMy WebLinkAboutF2024-0118 - PermitsaEwPoRr City of Newport Beach IIIII I I IIII II II I IIII III III IIIIIIII I II COMB Permit: F2024-0118 p4 a Community Development Department- Building Division F 2 0 2 4 - 0 1 1 8 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2024-0447 Permit Counter Phone: (949) 718-1888 Issued Date : 03/0612024 .M newportbeachca.gov/civic Final Date: c94FOR" �P Combination Type - Permit Status: Issued Work Class - Other 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 : 3536 COAST HWY E Legal Desc : N TR 323 BLK U LOT 4 TR 323 LOT 4 BLK U ALL -EX HW Description : COMM TANK FIRE SUPPRESSION SYSTEM (XC2023-0476)�(w�l, v Owner: JOHN BRADLEY PENCE Contractor : EDISON FIRE V ) Architee'c`t—: Address : 3416 VIA LIDO, G Address : 3621 EAGLE ROCK BLVD Address NEWPORT BEACH, CA 92663 Phone: (949)673-6333 Applicant: EDISON FIRE Address : 3621 EAGLE ROCK BLVD LOS ANGELES, CA 90065 Phone: (323)259-9999 Owner/Builder : Address : Phone LOS ANGELES, CA 90065 Phone : (323) 259-9999 Can State Lic : 569185 Lic Expire : 05/31/2025 Bus Lic: BT30069740 Bus I Expire : 11/30/2024 Workers' Compensation Insurance Carrier: STATE FUND Policy No: 9066898 W. C. Expire: 8/1/2024 Code Edition : 2022 Fire Sprinklers : YES Type of Construction : Fire Hazard Zone : NO Occupancy Groups : No of Units : 0 Bldg Height: No of Stories : 1 Building Setbacks : Flood Zone : X Use Zone: CC - Commercial Corridor PROCESSED BY: SPECIAL CONDITIONS: Phone: State Lic Engineer Address Phone: Designer: EDISON FIRE Address : 3621 EAGLE ROCK BLVD LOS ANGELES, CA 90065 Phone: (323)259-9999 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 penury that I am exempt from the Contactors' Slate License, Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items) 'action 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 re 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 rofessions Code) or that he or she is exempt from fieonsure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of at more than five hundred dollars (5�501 11, 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, asiness 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 nprovements are not intended proffered 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 rerovod for the purpose of sale). 1 I, as owner of the property, BUT exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pP y p property pprojects ant to the Contractors' State License Law). I ll am exempt from ensue Under the Contractors' hState nLicen eh Law for following reason:with a licensed Contractor pursuant w p ) P �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 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 he Business and 'rofessions Code, is available upon request when this application is submitted or at the following'Ned site:http:lAvww.leginfo.ca.gov/colaw.btml. signature of Property Owner or Authorized Agent ,,,_.�.__ __.__ _.__�._•,., Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of erjury ltlat,�I?m licensed under provisions of Chapter 9 (commencing with Section 4 0) of Division 3of the Business and Prq •fo s and. my license is In full force nd effect License Class �N License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE THOUSAND DOLLARS ($100,000), IN ADINTION TOTHE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, ANO ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 3 1 have and will maintain a certificate of consent to self -insure for workers' compensation. Issued by Ilia Director of Industrial Relations as provided for by Section 3700 of the Labor Cade, for IN erformance of the work for which this permit is issued. Policy No. Jbave 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' cpmpensatior Jranceecaririer �an"d policy number are: �y / 7 r� '7 / `/ Tier Tim, 1-r-�'�-C� Policy Number "I L1 J V 7 > ��3 Expiration Date / ) (�� 7 me of Agent Phone # certify that, in the performance of the work for which this permit is issued, I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California. and agree t, if I should beep Kb,,oqt t workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant DatCivil CLARATION REGAINSTRUCTION LENDING AGENCY arebyaffirmunder pOury that three is a construction lending agency for the perfdrmance of he work for which this permit is issued QSectlon 3097, C vil Code). lder s Name Lender's Address my. signature below, I certify to each of the following: I am the property owner or authorized to apt on the properly owner's behalf. ve raid this application and he have I agree to comply with all representatives of fthis city city and city ordmanc ate Ia6Ve relating r building Construction. coon. Coses.r ? e 11w,,,a,^, D v �7 / 4 .nature of Property Owthorize er or Authorized tdAgeno yllo rent provided Is property for inspection Print Property Owner's or Authorized Agent's Name O y91 YDatB 7 b /� 1 DATE BY / DECLARh1fION. OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RFGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED ,;-0i-, B'AI'TE? ASREaT05 NOTIFICATION TO PERMIT CANCELLED ZiC.F PERMIT FINAL ,f 11 tIUU'LVtAt5V ASBESTOS N011FICAHON 15 NOT APPLICABLE TO CERTIFICATE OF Ij E{p PROAOSFO DEMOLITinN OCCUPANCY ISSUED %IG A-URE.