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Home My WebLink AboutF2018-0325 - Permits (3)wr(:; City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIBIII�IIIIIIIIIIIII II FIRE Permit: F2018-0325 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 8 0 3 2 5 Project No: 1308-2018 1. Permit Counter Phone (949)644-3288 - - Inspection Requests Phone (949)644-3255 PROCESSED BY: o •04HEI; DEPA`iJQIFN ZONING APPROVAL: ° ° i. u • o N -AN GAE6:KEb BY:1 E G G t •a 6' •4 E G FIRE APPROVAL: • • • • APPROVAL TO ISSUE:. ccc c. o 0 o•c co PERMIT EXPIRES 180 DAYS AFTER f3S1PA#CB OV 1<:41T GALle f rSPECTION FEES Job Address: 409 N BAY FRONT NIS Construction Valuation: Description: SFR FIRE SPRINKLERS 33 HEADS (X2017-1348) •REVI IED Building PC Fee: $190.00. Fire Residential Alarm PC Fee: $0.00 Records Management: Inspector Area: 2 Legal Description: BALBOA ISLAND RESUB SEC 1 BILK 8 LOT 5'> Planning Counter Review: $0.00 Owner: ' GUNDERSON DAVE Contractor: KELLY FIRE PROT INC Architect:+ $0.00 Address: 408 N. BAY FRINT Address:. 10141 THESEUS DR Address: $0.00 -� NEWPORT BEACH,. CA -. HUNTINGTON BCH CA 92646 $0.00 Fire Permit Fee : $0.00 Phone: Phone: 714.907-7586 Phone: State Lie: Applicant: KELLY SEAN .Con State Lie: 878823 Engineer. Plan Check Fee: 'y9 Address: 10141 THESUS DR Lie Expire 08/31/2019 Address: HUNTINGTON BEACH, CA 92646 Bus Lie: BT30042225 Phone: 714-907.7586 Lie Exp Date: 01131/2020 Phone: State Lic: Code Edit : 2016 Worker's Compensation Insurance Designer: KELLY SEAN Type of Construction: V-BSPR Carrier: AMERICAN FAM HOM INS Address:.. 10141 THESUS DR Occupancy Group:. R31U Policy No: 2EASWC000024603 HUNTINGTON BEACH, CA 92646 Added /New sq.ft:. Bldg: 0 Expire: 04111/2020 Phone: 714-907.7586. Added /New sq. ft. Garage: 0 No of Stories: 3 Issued Date: 0610412018 Special Conditions: REV18.1297 . No of Units : 0. Setback- Front: Flood Zone: Rear. Bldg Sprinklers: N Left: Right: PROCESSED BY: o •04HEI; DEPA`iJQIFN ZONING APPROVAL: ° ° i. u • o N -AN GAE6:KEb BY:1 E G G t •a 6' •4 E G FIRE APPROVAL: • • • • APPROVAL TO ISSUE:. ccc c. o 0 o•c co PERMIT EXPIRES 180 DAYS AFTER f3S1PA#CB OV 1<:41T GALle f rSPECTION FEES Construction Valuation: $3,800.00 Building PC Fee: $190.00. Fire Residential Alarm PC Fee: $0.00 Records Management: $2.00 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 : $417.00 Plan Check Fee: $417.00 Fee Due at Permit Issuance : $0.00 PROCESSED BY: o •04HEI; DEPA`iJQIFN ZONING APPROVAL: ° ° i. u • o N -AN GAE6:KEb BY:1 E G G t •a 6' •4 E G FIRE APPROVAL: • • • • APPROVAL TO ISSUE:. ccc c. o 0 o•c co PERMIT EXPIRES 180 DAYS AFTER f3S1PA#CB OV 1<:41T GALle f rSPECTION DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable tel lection 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 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 '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 U 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 n roved for the purpose of sale). 1 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). I 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 penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. ` / icense Class License No Date_X_� t Contractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 130L 100,0001, IN "ITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 3700 of the Labor Code, for th' 91formance of the work for which this permit is issued. Policy No. I have and will i.Main 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' compensatio surance carrier a glicy number are:. �} /'� �+ arrier i 1 �i..l+,ol1'�wt,,Nu b Expiration Date Name of Agent — Ar Phone # I certify that, in the performance of the work 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 that, if I should become subject tot workers' compensation provisions ofSection 3700 of the Labor Code, I shall forthwith comply with thDafe pro �sions. Signature of Applicant XXi !!�� 9 �I— DECLARATION REGAR IN CONSTRUCTION A v I hereby affirm under pe of perjury that there is a cons cti n lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and slate laws relating to building construction. I authorize representatives of this city or county to to h above -idle ified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name I'✓�^-� �L k'.C.L ACTION DATE BY ><DECLARATION OF COMPL/ANCEtMTH CODEOF FOR OFFICE USE ONLY EDERAL REGULATIONS PART 01 OFTITCE40.AND PERMtTEXPlR€Q • QMD ABLE 1403.• • • l tSUIiMITTE®A5BtSjOS NOTIFICATION TO: PERMITCANCELLED i i i • ••❑ •,SPA •i i i PERMIT€XTENDED • • 0 •AQMD- ❑ ASBESTOS NOTLFICARONIS NOT APPLICABLE TO PERMITFINAL PROPOSEDDEMOLITION C€RTiF1CATEOF . ..• • • SiGAL4TIR:: OCCUPANCYtSSOED • • • • • • • •