HomeMy WebLinkAboutF2017-0119 - Permitsy;W1y-r4' City of Newport Beach - Building Division *F2017-0119*
r3 4 100 Civic Center Drive, Newport Beach, CA 92660
H ' Permit Counter Phone (949)644-3288
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Job Address: 1501 SERENADE TER NB
Inspector Area: 2
Owner: SERENADE TERRACE LLC
Address: 428 OLD NEWPORT BLVD
NEWPORT BEACH, CA 92663
Phone:
Applicant:
FIRE SPRINKLER SYSTEMS INC
Address:
705 E HARRISON #200
Address:
CORONA CA 92879
Phone:
800-915.3473
Code Edit: 2016
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
R3/U
0
0
FIRE Permit: F2017-0119
Project No : 0417-2017
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS 36 HEADS (X2017-3663)
Legal Description:
N TR 1701 LOT 39
Contractor:
FIRE SPRINKLER SYSTEMS INC
Address:
705 E HARRISON #200
INS CO OF THE WEST
CORONA CA 92879
Phone:
800-915-3473
Con State Lic: 684600
Lic Expire: 02/2812018
Bus Lic:
BT30027990
Lic Exp Date:
05/2012018
Worker's Compensation Insurance
Carrier:
INS CO OF THE WEST
Policy No:
WSD5031314
Expire:
1010112018
1 Issued Date: 02124/2017
0 Setback- Front:
Rear:
N Left:
Right:
Architect:
Address:
.� >>i'COR
Phone:
State Lic:
Engineer:
FEES
Address:
00 0 0 0
° ° °°°°
Construction Valuation:
$5,710.00
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Building PC Fee:
Phone:
State Lic:
$0.00 Records Management:
$8.00
Building Overtime PC Fee:
$0.00
oceo
$0.00
Designer:
FIRE SPRINKLER SYSTEMS
INS °
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°
° ° • • °
Address:
705 E HARRISON #200
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CORONA CA 92879
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_. ° °. °.°„
Phone:
Public Works PC Fee :
e
$0.00
Fire Permit Fee :
$0.00
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0 0
Special Conditions:
PERMIT REVISED 01-03-18
$225.00
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00°00
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Plan Check Fee :
$423.00 Fee Due at Permit Issuance:
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PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE: Q --
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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FEES
00 0 0 0
° ° °°°°
Construction Valuation:
$5,710.00
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 :
$423.00 Fee Due at Permit Issuance:
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE: Q --
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
"X0
)WNER-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
to 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 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
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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 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).
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
pply 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).
1 am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
'signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under Qenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se Ion 7 00) of Division 3 of th Business and f ssions Cod and,Yn license is in 11 fort
nd effect. ,".
icenseClass 00** License No 3jgt'a ( 3 / Contra ignature
MRKjRS' C4MFMSATION DECLARATION j
q12NIN(j: FAILURE TO SECGRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN DOLLARS ($100,000), IN ADDITION TO THE
p$j' OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereU'y affirm undanpenalty of perjury one of the following declarations:
:rh¢%J9 and wftl'fi9intain 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
Mormance of thew oWor which this permit is issued. Policy No.
sand 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 arfd policy number are:
Policy Number Expiration Date
paAgent -
Wt4 that, in (11b ppI formance of tte work f9P19hich this
if I should becomebj. t to the Wb s' o pensatio
rture of Ap ant
I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
.ction 3700 of the Labor Code, I shall forthwith comply with thosetprovisions. I _ / -
;reby affirm under penalty of perjury t1 ht there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
iders 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 cgaR(y ordinances at stat ws relati to buil ing construction.
1 authorize representatives of thi�eity or county to thg above -i of d propeq ins action purposes.
of PrODertv Owner
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