HomeMy WebLinkAboutF2017-0388 - PermitsQ'
City.of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII FIRE Permit: F2017-0388
a' 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 7 0 3 8 e Project No: 1730-2017
Permit Counter Phone (949)644-3288
"d+rroa�' Inspection Requests Phone (949)644-3255
r, . I .
Job Address: 745 DOVER DR NB
Description: COMM UNDERGROUND FIRE LINE
C
Construction Valuation:
InspectorArea: FIRE
Legal Description:
TR 1218 LOT 148 POR OF LOT (P.
M. 160.03 PAR 3 POR OF PAR)
Building PC Fee:
01P
Owner: ENVIRONMENTAL NATURE CENTER
Contractor:
CONSOLIDATED CONTRACTING
SERVICES INC Architect:
WIRICK JAMES
Planning Counter Review:
$0.00
Address: 1601 E 16TH STREET
Address:
181 AVENIDA LA PATA #200
Address:
5161 CALIFORNIA AVE #100
Building Investigation Fee:
NEWPORT BEACH CA 92663
SAN CLEMENTE CA 92673
$0.00
IRVINE CA 92617
$355.00
Public Works PC Fee :
Phone:
Phone:
949-498-7992
Phone:
949-261-1001 State Lie: C015598
$0.00
Applicant: SHULMAN GINGER
Con State Lie:
475813
Engineer:
SEAMIER BRYAN GEOFFREY
....
TOTAL FEE :
Address: 5161 CALIFORNIA AVE #100
Lie Expire:
06130/2019
Address:
31821 VIA ALLEGRE
° • ° ° •'
IRVINE CA 92617
Bus Lie:
BT0054584
TRABUCO CANYON CA 92679
e °°
Phone: 949-261.1001
Lie Exp Date:
04/30/2019
Phone:
• ° e °
949-769.6206 State Lie: S-004899
oc
° e. o
Code Edit :201'8
Worker's Compensation Insurance
Designer:
•
0 0
• • °
Type of Construction:
Carrier:
TRAVELERS INDEMNITY
Address:
....
O° °
Occupancy Group: U
Policy No:
DTJUB3780C317
Added /New sq.ft. Bldg: 0
Expire:
05101/2019
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Issued Date: 07/02/2016
Special Conditions:
No of Units : 0
Setback- Front:
°
°m0000
0
Flood Zone: X
Rear:
i
°
...... °°°°
Bldg Sprinklers: N
Left:
Right:
o°Go°o
0000
PROCESSED BY: I-�4P.e.�^�r "
ZONING APPROVAL: I /
FIRE APPROVAL: - �V
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$42,000.00
Building PC Fee:
$0.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
$0.00
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:
$355.00
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$362.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$355.00
Plan Check Fee :
$355.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY: I-�4P.e.�^�r "
ZONING APPROVAL: I /
FIRE APPROVAL: - �V
OTHER DEPARTMENT:
PLAN CHECKED BY::
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)
action 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
siness 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
)rovAments 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
iioved 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 tq 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:
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 legalh
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
ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nature of Property Owner or Authorized Agent Date
TENSED CQNMCTOR'S DECLARATION
)rebyaffirm un'dMi jfenalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the Business andZrIons Code, and my license is in full force
i'ef eFt. • • • • /
ense Class • • License No Date ��" ! Contractor Signature
YliERS' COBIPENSATION DECLARATION
ZNINF.: FAILURE 70SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU D THOUSAND DOLLARS ($'100,000), IN ADDITION TO THE
go POMPEN04TJpjd•ITAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
:rte affirm urgter gpnalty of perjury one of the following declarations:
I have and wilF 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
%rmance of thework for which this permit is issued. Policy No.
•havO and vfjlj gVaain 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' compensatioi
Trance carrier and policy number are:
ivr • • • • Policy Number Expiration Date
1e of Agent • • • Phone #
certify that, in the pertggrmance a work for which this perm}y_ is -issued, I shall not employ any person in any manner so as to become subjec�to
if I should become a biect h workers' compensatioD•ptovisions of Section 3700 of the Labor Code, I shall forthwith comply with those probisiD
the workers' compensation laws of California, and
nature of Applicant
uare
.>—
CLARATION REGA ING CO JS r CT9 ENDING AGENCY
Ireby affirm under p alty of p ju I e ere 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 tach of the following:
/f
I am the property owner ora )orized to act on the property owner's �ialf.
I have read this application and the information I hav provided is rect.
I agree to comply with all applicable city and county rdinanc d state laws relating to 'IdI construction.
I authorize representatives of this city or county to St!We a v Identified pr or inspection purposes.
nature of Property Owner or Authorized Agent
Print Property Owner's or Authorized Agent's Name
i
ACT70N DATE Y
DE CEA RA TION OF COMPLIANCEM T HCODEOF
FOR OFFICE tI
FEDERAL REGULATIONS PART 67 OF TITLE 40 AND
AQMDRULE 1403.
E SUBMITTED ASBESTOS X071FICATIOIV TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIRCATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT EXPIRED
PERMITCANCELLED
PERMITEXTENDED
PERMITFINAL i7
CER77RCATEOF
OCCUPANCYISSUED
SIGNATURE:
fJ