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F2018-0335 - Permits (2)
h City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 :C`�LlRltt��� Job Address: 3725 OCEAN BLVD NB Inspector Area: 5 Owner: FISCHER DESMOND LAWRENCE Address: PO BOX 65 OOLTEWAH TN 37363 Phone: Applicant: FIREPROOF FIRE PROTECTION Address: 1101 KINGSTON OR Occupancy Group: LA HABRA CA 90631 Phone: 714-476-5370 Code Edit: 2016 CORONA DEL MAR LOT BLK A POR OF BLK Type of Construction: _ V-BSPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 3 No of Units : 0 Flood Zone: BT30040107 Bldg Sprinklers: Y II IF I I VIII 0�I�I I�I III 0�I�� I �3 IIII I 5II I FIRE Permit: F2018-0335 Project No : 1369-2018 Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLERS (56 HEADS) X2015-1631 Legal Description: CORONA DEL MAR LOT BLK A POR OF BLK Contractor: FIREPROOF FIRE PROTECTION Address: 1101 KINGSTON DR LA HABRA CA 90631 Phone: 714.476.5370 Con State Lie: 876004 Lie Expire: 04130/2020 Bus Lie: BT30040107 Lie Exp Date: 08/3112018 Worker's Compensation Insurance Carrier: NORGUARD INS CO Policy No: MOWC901180 . Expire: 02115/2019 Issued Date: 06/08/2018 Setback- Front: Rear: Left: Right: Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: INSPE"CTOR State Lie: State Lie: CASEY MONTY 1101 KINGSTON DR LA HABRA CA 90631 o c oeeocf, 0 00000 e eoeno OOQQ UC a o 0 © J YeeY.e e e FEES Construction Valuation: $5,600.00 Building PC Fee: $190.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $4.00 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 : $419.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $419.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: 0� PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 (_) all of or U 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'purpoae of soli. s: z ❑ 1, as owner oftheproperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not appiylo an ownsr.ofproperty who builds or jmproves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempA" licensure under the° ontractors' State License Law for the following reason: Ayjpy $ignature.beow I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall sell a structure$hdtJ j Ive 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 Nofessions Code.is available upon request when this application is submitted or at the following Web site:http://v w .leginfo.ca.gov/calaw.htmi. .&NOre of Property Owner or Authorized Agent Date QCEWSED CCMfAACTOR'S DECLARATION t hBrp4f affirm uRder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines and Professions Code, and my lic Be is in full force and effect. ` cense.Class - • ` `� License No Date Contractor Signatu ..... WORK€RS' COMPENSATION DECLARATION AIARNING!FAILURJ,' q%F�ptIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOL RS 700,0001, IN ADDITION TO THE DOSTOFCOMPEN ION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Ifhlb?dby;affirm under.penalty of perjury one of the following declarations: Qhave and wAl ITibintain 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 performance of the work for which this permit is issued. Policy No. have and will ms rance carrier and of Agent 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' -olWrnbern n Expiration Date certify that, in the performance of the work . if I should become subject to the workers' of i 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 I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. CLARATION REGAIWIIRG COWSTRUCTIONN+ANMNG AGENCY / - ' ;reby affirm under penalty of perjury that the r I, onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 county ordinances and state I� I authorize representatives of this city or county tq gatlr the above-identifiec or ,s relating to building construction. property for inspection purposes. ACTION DATE BY DECLARATION OF COMPLIANCEtMTH CODEOF FOR OFFICE USE ONLY DERAIL REGULATIONS PART 61 OF TITLE40AND 4C MD PFRMITEXPdRED ❑ I SUBMITTEDASSESTOS LJO77FlCATION TOc ❑ EPA ❑ AQMD PERMITCANCELLED PERMITE.YTENDED ❑ ASBESTOS NOTIFICA170NIS NOT APPLICABLE TO PERMIT FINAL POSED DEMOLITION - CERTIRCATEOF SIGNATURE: OCCUPANCYdSSUED