HomeMy WebLinkAboutF2019-0334 - Permitsa City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII
FIRE Permit: F2019-0334
100 Civic Center Drive, Newport Beach,
CA 92660
$500.00
F 2 0 1 9 0 3
3 4
Project No: 1258-2019
$0.00
E _ Permit Counter Phone (949)644-3288
$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
"c�Nrx7.¢x'
Building Investigation Fee:
'$0.00.
Inspection Requests Phone (949)644-3255
$0.00
Fire Plan Check Fee: -
$146.00.
Public Works PC Fee :
I-IG:
ESAYZLL Ln SLG
Fire Permit Fee:
$188.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
Job Address: 2547 EASTBLUFF DR NB
Description: COMM FIRE SPRINKLERS 5 HEADS (X2019-1027)
TOTAL FEE :
Inspector Area FIRE
Legal Description:
PM 49-22 PARS 23 & POR PAR 1.
$336.00
Fa
Owner. -IRVINE COMPANY
Contractor:
APEX FIRE SYSTEMS INC
Architect
Address: 550 NEWPORT CENTER DR
Address:
18009 SKY PARK CIRCLE #L
Address`.
• • • e
• a
NEWPORT BEACH, CA 92660
IRVINE CA 92614
•ee.
Phone:.
Phone:
949.387-2859
,Phone:
State Lie ....
Applicant, APEX FIRE SYSTEMS INC
Con State Lie:
732396.
Engineer.
Address: 18009 SKY PARK CIRCLE #L
Lie Expire:
09/3012019 '
Address:.
" '
• • o
.IRVINE CA 92614
Bus Lic:
BT30006908
eee.
°
e• o
Phone: - 949.387-2859
Lie Exp Date:
01/3112020
Phone:
State Lie:
Code Edit: 2016
Worker's Compensation
Insurance
Designer:
LOPEZ CARLOS .... eee
Type of Construction: V-B-SPR
Carrier: -
EMPLOYEE SVC GRP
Address:
18009 SKY PARK CIRCLE #L
Occupancy Group: B
Policy No;
RWCC64404362
IRVINE CA 82614 °
Added /New sq.ft. Bldg: 0
Expire:
1110112019
Phone:
e
949-387-2859 ° e e ° e e
° • °
Added /New sq ft. Garage: 0
No of Stories: 1
Issued Date: 06/0412019
Special Conditions:
P
° ° •
e
m ° ° ° ° o
No of Units ; 0
Setback- Front:
e
....
....
Flood Zone:
Rear.
Bldg Sprinklers: N
Left:
Right
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$500.00
Building PC Fee :
$0.00
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: -
$146.00.
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee:
$188.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTAL FEE :
$336.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$336.00
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
IINER-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)
Iction 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
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
Ifessions 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
more than five hundred dollars ($500).
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,
ainess 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
)rovements 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
)roved 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
)ly 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 frm licensure under the Contractors' State License Law for the following reason:
M, signature ti Sow 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
a structure'tAAM 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
Ifessions C04-Bavailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
nature of droperly Owner or Authorized Agent Date
IEPSED CONTRACTOR'S DECLARATION
."by affirm yodar penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business a PrPP�
s Codeand my license is in full force
I effect. `....
3gze Class. License No Date ! l9 Contractor Signatur z ✓ti /`T _
3RKERS' CQIh1PFNSATION DECLARATION
WHIG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
IT OF COMPENSA`hON, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Ireby affirm LIDdBr uenalty of perjury one of the following declarations:
I,haue 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 thf
forg,lhnce of.the wo for which this permit is issued. Policy No.
have 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' compensatior
barite carrier and policy number are:
Policy Number
re of Agent Phone
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 si
, if I should become su ' c o th orkers' cgmpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
iature of Applicant '�//��%C Date
:reby affirm under pe f alty 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, 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 GOunty ordinances and state laws relating to building construction.
I authorize representatives of this city or countyled property for inspection purposes.
t e the ve-I
nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent
Date
the workers' compensation laws of California, and
(Section 3097, Civil Code).
6_
ACTION
DATE BY
DECLARATION OF COMPLIANCEMTR CODE OF
FOR OFRCE USEONL.
FEDERAL REGULATIONS PART 61 OF 777LE40AND
AOMDRULE1403.
PERMITEXP/R€D
❑ f SUBMITTED ASBESTOS NOTIFICATION TO:.
❑ EPA
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PERMITCANC€LLEO
PERMIT€XTENDED
ASBESTOS UOIIRCARONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
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CERTPFICATEOF
SIGNATURE:
OCCUPANCYISSUED