HomeMy WebLinkAboutF2018-0441 - Permits�� ,• -City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIII�IINIIIIIIIIIIIIIII II
4 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 8 0 4 4 1
t=� Permit Counter Phone (949)644-3288
fi"�igenw��°
Job Address: 205 GRAND CANAL NB
Inspector Area: 2
Owner: BERL FAMILY TRUST
Address: 211 OPAL AVE
NEWPORT BEACH, CA 92662
Phone:
Applicant: H 2 O FIRE PROTECTION INC
Address: 417-B FOOTHILL BLVD, #282
GLENDORA CA 91741
Phone: 909-394.7979
Code Edit: 2016
BALBOA ISLAND SEC 4 BILK 11 LOT 28
Type of Construction:
V-BSPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
0
Flood Zone:
8730042644- k_p -4 t S3
Bldg Sprinklers:
Y
FIRE Permit: F2018-0441
Project No: 1911-2018
Inspection Requests Phone (949)644-3255
Description: MFR SPRINKLER ADD (30 HEADS) X2017.1857
Legal Description:
BALBOA ISLAND SEC 4 BILK 11 LOT 28
Contractor:
H 2 O FIRE PROTECTION INC
Address:
417-B FOOTHILL BLVD, #282
GLENDORA CA 91741
Phone:
909-394-7979
Con State Lie:
897997
Lie Expire:
06130/2020
Bus Lie:
8730042644- k_p -4 t S3
Lie Exp Date:
0 813112 01 9
Worker's Compensation Insurance
Carrier:
BENCHMARK
Policy No:
CST5011543
Expire:
1210112018
Issued Date: 0811312018
Setback- Front:
Rear:
Left:
Right:
TOR
Architect.
Address: vi
Phone: State Lie:
Engineer:
Address:
Phone: State Lie
Designer: SERHAL DANNY
Address: 417-B FOOTHILL BLVD, #282
GLENDORA CA 91741
Phone:
Special Conditions:
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PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$1,500.00
Building PC Fee:
$190.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
$8.00
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 :
$423.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$423.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -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
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 purpose of sale).
❑ 1, 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
apply 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).
❑ 1 am exempt from licensure under the. Contractors' State License Law for the following reason:
By mysignature 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
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CdjyTRACTOR'S DECLARATION
• I hereby affil ipn der penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3-o a Business and Professions Code, and my license is in full force
•• dliffect A�I
Licehse Clan°s. " License No Gct Date - ---C I nature L�6Lri r t -
' •
• WtIRKERe CUMPENSATION 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 DOLLARS ($100,000), IN ADDITION TO THE
• COST OF COVrNSAAON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
• 1 kereby affirm under penalty of perjury one of the following declarations:
•" • I have:ard %% maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
' • • rformancg of the work for which this permit is issued. Policy No.
• •: hav��avd will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol
Ing' aancee-oefrjej nd policy number are:
• • Q$rrier C?itior AA'N X Ac i, tgo ) rts.)f Policy Number C STr t J �1 Expiration Date A? 11. 1152,
'• � '• nN! Phone# WLi, 3U 5J5:33
Tame ofA•gent .�� -� C M, �,\
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 sub�I�cct- 944 workers' compensation laws of California, and agre
that, if I should become smbiect to tjle workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith complywittl�hya�provisions.
DECLARATIOWREGARDING CONSTRUCTION LENDING AGENCY
I hereby 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).
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 owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply wi! a1Lep icable city and county ordinances and state laws relating to building construction.
I authorize representatives his city or county enter the above -identified property for inspection purposes. _
Signature of Property'6wn or Authorized Agent Print Property Owner's or Authorized Agent's Name &VL 26fre'�Eoaf�
ACTION DATE BY
DECLARATION OF COMPLIANCE ANITN CODED
/ FOR OFFICE NLY
FEDERAL REGULATIONS PART fig OFTITLE4,oum -----
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I SUBMITTED ASBESTOS NOTIFICATION TO:
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PROPOSED DEMOLITION.
PERMITEXPIRED
PERMITCANCELL€D
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PERMIT FINAL
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED
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