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Home My WebLink AboutF2019-0405 - Permits' t City of Newport Beach - Building Division IIIIIIIIIIIIIIIIILIIIII�III�IIIIIIIIIIII II FIRE Permit: F2019-0405 100 Civic Center Drive, Newport Beach, CA 92660 IIU F 2 0 1 9 0 4 0 s Project No: 1576-2019 Permit Counter Phone (949)644-3288 - '!drnne`' inspection Requests Phone (949)644-3255 Job Address: 520 NErPeORT CENTER DR NB St: 1 FI: 11 Unit: 1100 Description: COMM FIRE SPRINKLER - (1) HEAD x2019-1583 0c P.. IO G Insiptitfidr°Area FIRE -® Legal Description: OWPftF, <c.. THE IRVINE CO: Contractor: FIRE PROT SPECIALISTS Architect:. Adgrpg%:,r 111 INNOVATION :Address: 2810 E MIRALOMA AVE Address: C IRVI}41E CA 92618 ANAHEIM CA 92806 eeo Ph one:' Phone: 714-635.6500 Phone: State Lie: Applieantr� LUDVI /FNE PROTECTION SPECIALISTS Con State Lie: 464915 a5 Engineer. Addsessa o 2810 E MIRALOMA AV Lie Expire 10131/2020 ft" Address: - t<o oe ANAHEIM CA 92806 Bus tic ST30042894 ' Phone. < ,- ° < Lie Exp Date: 05131/2020 ` Phone: State Lie: Cod9 Edit: 2016 Worker's Compensation 0 0 < : Type of Constructioho o , c ` V -B -SPR Carrier: InsuranDesigner: COMP WES Address: ANDERSON ROBERT 2810 E MIRALOMA AV Occupancy Group: IS Policy No: WCV55029 Aa ANAHEIM CA 92806 Added /New sq.ft. Bldg: 0 Expire: - 12/02120Q , Phone: 714.636.6500 Added /New sq ft. Garage: 0 �' N"^ '3 No of Stories' 11 Issued Date: 07/15@019 Special Conditions: No of Units : 0 Setback- Front Flood Zone: - Rear.. - Bldg Sprinklers: Y Left: Right FEES Construction Valuation: $1,100.00 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: $138.00 Public Works PC Fee: $0.00 $0.00 Fire Permit Fee : $176.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $0.00 TOTAL FEE : $316.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $316.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION )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 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 th4itNs not built or »proved for the purpose of sale). • • • .00. 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 Ljcense Law doas>ror.• o 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: • ° ° ° O d 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 ppermit, I cannf)( Wgoll 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 ,A4Bl sinesslhpg 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. 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 7 00) of Division 3 of the Business and Prof ins Code, and my license is in fVn f9(ceP nd effect. icense Class License No Date S/ ( Contractor SignatureirNj • e • VORKERS' COMPENSATION DECLARATION . •.,n • c DARNING: 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 ($101,QOSrf IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 the e ronce of the work for which this permit is issued. Policy No. 3 a 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 Brice carrier and policy number are: :arrier Policy Number Expiration Date lame of Agent Phone # ]I certify that, in the performanc f 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 agree tat, if I should Thecome�s(ubject compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision)`11// ignature of Applicant P /T DatV —7)/ 1 / CLARATION REGARDING MNSTRUCTION LENDING AGENCY V/ =.reby affirm under penalty of perjury that there is a construction 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. 1 agree to comply with all applicable city and county ordinances and a laws relating to building construction. 1 I authorize representatives of this city or county to enter the above d arty for inspection purposes. � V n '� 1,."161 � Lt nature of Property Owner or Authorized Agent I.A Print Property Owners or Authorized Agent's Name 7 Date S ACTION DATE BY DECLARATION OFCOMPL(ANCEWITHCODEOF FOR OFFICE USE ONLY. FEDERAL REGULATIONS PART 61 OFTfTLE40AND PERMITEXP/RED AQMDRULE1403. ❑ I SUBMfTTEDASBESTOS NOTIFICATION T0: PERMITCANCELLED ❑ EPA PERMITEXTENDED ❑ AQMD.. ❑ ASBESTOS NOEflCADONIS NOT. APPLICABLE TO FERMfTFfNAE mo rZyA PROPOSEDDEMOLITION. CERTIFICATE OF OCCUPANCYISSUEO SIGNATURE: