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F2017-0475 - Permits (2)
v1a City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 7 0 4 7 5 ` Permit Counter Phone (949)644-3288 Job Address: 218 CORAL AVE NB Inspector Area: 2 Owner: TJC CAPITAL OPPORTUNITY Address: 26940 ALISO VIEJO PKWY #100 ALISO VIEJO CA 921656 Phone: Applicant: MAJESTIC FIRE PROTECTION Address: 16134 VALERIO ST VAN NUYS CA 91406 Phone: 800-299-2092 Contractor: Code Edit: 2016 Address: Type of Construction: V -B -SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units: 0 Flood Zone: $0.00 Bldg Sprinklers: N FIRE Permit: F2017-0475 Project No: 1999-2017 Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLERS 25 HEADS (X2016-3684) Legal Description: BALBOA ISLAND SEC 3 BLK 7 LOT 19 Contractor: MAJESTIC FIRE PROTECTION Address: 16134 VALERIO ST STATE FUND VAN NUYS CA 91406 Phone: 800-299-2092 Con State Lic: 772753 Lic Expire: 12131/2017 Bus Lic: BT30056513 Lic Exp Date: 09/3012017 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9103983 Expire: 06125/2018 Issued Date: 09107/2017 Setback- Front: Rear: Left: Right: Architect Address: Phone: State Lic Engineer: Address: Phone: State Lic Designer: PEDERSON BURTON Address: 16134 VALERIO ST VAN NUYS, CA 91406 Phone: 213.422.6716 Special Conditions: c e r� e ud O o ee `�` �> p�e•oo omm• ' ease ss, •eeo :::e e'�c 000 0 :•�' 'A�/ .e 6e00 e mommoc a o o e o moesmo m O 0 ote•oo Omm O £ U m m memo mm PROCESSED BY: sr -/4 - � OTHER DEPARTMENT: FEES PLAN CHECKED BY:: FIRE APPROVAL: Construction Valuation: $5,000.00 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Building PC Fee: $190.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $8.00 Building Overtime PC Fee: $0.00 Planning Counter Review: $0.00 Building Extention Fee : $0.00 Planning Zoning PC Fee : $0.00 Building Investigation Fee: $0.00 $0.00 Fire Plan Check Fee: $0.00 Public Works PC Fee : $0.00 $0.00 Fire Permit Fee : $0.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee: $225.00 TOTAL FEE : $423.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $423.00 PROCESSED BY: sr -/4 - � OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: S67 APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -BUILDER DECLARATION 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 item(s) (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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owne6gf.%operty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exemp? frQr6 icensure under the Contractors' State License Law for the following reason: By rpy � Onature gEgow Lacknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legail 0II a sticture *at I -have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Prpfessions Code, s available upon request when this application is submitted or at the following Web site:htt //www.le info.ca. ov/calaw.htmi. P q PP 9 P� 9� 9 Bigr%ijrE of Property Owner or Authorized Agent Date LI9EtJSED CQNTR5%CTOR'S DECLARATION 111erebyeffirm unelel•penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wi Section 7000) of Division 3 of the Business and Pro sions Code, d my license is in full force and e$ect. CdbT�9� Glass e "/CY License No � 7� �� Da ! 7/ Contractor Signature J'7 VY rW�ERS' COMPENSATION DECLARATION *ACIN&:�AILURE Tp SECINiE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN E LOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE UNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF EOMPENSRTIORM MAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 410110by Bffirm underpenalty of perjury one of the following declarations: :N'11dire and jig 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 the )ertormance 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 Dolicv number are: Policy Number Expiration Date is of Agent Phone; certify that, in the pert mance of the w rk for which this permit is issued, I shall not employ any person in any manner so as to become SL if I should become ubje�to the„y+or rscompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Iature of App lica Datp CLARATION R ARDING CONSTRUCTION LENDING AGENCY Ireby affirm un er penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is Ider's Name Lender's Address my signature below, 1 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 rovided is correct. 1 agree to comply with all applicable city and county or finances and #ate laws relating to building construction. I authorize representatives of this city or county toe er a e -I entified property for inspection purposes. nature of Property Owner or Authorized AGent Print Property Owner's or Authorized Agenl ACTION I DATE I / BY W=111[0401 0413 I PERMlTCANCEIIED I PERMIT EXTENDED f „ OCCUPANCYtSSUED 61' OF TITLE40AND p f SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS N07IRCAIIOMIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE., the workers' compensation laws of California, and .01P7 (Section 3097, Civil Code). 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