HomeMy WebLinkAboutF2017-0137 - PermitsCity of Newport Beach - Building Division IIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII II
+� 10D Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 7 0 1 3 7
Permit Counter Phone (949)644-3288
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Job Address: 6802 W OCEAN FRONT NB
Inspector Area: 1
ADJ-(AND POR
Owner:
BOBLOT STEVEN
Address:
1733 MONROVIA AVE #V
Added /New sq.ft. Bldg:
COSTA MESA, CA 92627
Phone:
0
Applicant:
MEDINA MARTIN
Address:
705 E HARRISON ST #200
Flood Zone:
CORONA CE 92879
Phone:
951-272-2522
Code Edit: 2016
Type of Construction:
V -B -SPR
Occupancy Group:
R3/LI
Added /New sq.ft. Bldg:
2464
Added /New sq. ft. Garage:
0
No of Stories:
3
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
FIRE Permit: F2017-0137
Project No : 0517-2017
0
Inspection Requests Phone (949)644:255
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Description: NEW SFR FIRE SPRINKLERS (.'P(:ppJ-IEADS) X2016.1290
Legal Description: SEASHORE COLONY TR LOT 1 BILK H POR OF LANK POROF ST
Contractor:
FIRE SPRINKLER SYSTEMS INC
Architect:
Address:
705 E HARRISON #200
Address:
WSD503131400
CORONA CA 92879
Expire:
Phone:
600-915-3473
Phone:
Con State Lic:
664600
Engineer:
Lic Expire:
02/28/2018
Address:
Bus Lic:
BT30027990
Left:
Lic Exp Date:
05/20/2017
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
INS CO OF THE WEST
Address:
Policy No:
WSD503131400
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALIE) INSPECTION - _ -- ----- -- 1
Expire:
10/01/2017
Phone:
Issued Date:
03/09/2017
Special Conditions:
Setback- Front:
State Lic: •
om
mem ° ° °
Rear:
$0.00
Left:
$0.00
Planning Zoning PC Fee :
Right:
Building Investigation Fee :
State Lic:
SANCHEZ URIEL
705 E HARRISON ST #200
CORONA CA 92879
951-272-2522
OTHER DEPARTMENT:
FEES
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� ° °
$4,742.00
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALIE) INSPECTION - _ -- ----- -- 1
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0
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State Lic: •
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State Lic:
SANCHEZ URIEL
705 E HARRISON ST #200
CORONA CA 92879
951-272-2522
PROCESSED BY:
OTHER DEPARTMENT:
FEES
PLAN CHECKED BY::
FIRE APPROVAL:
Construction Valuation:
$4,742.00
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALIE) INSPECTION - _ -- ----- -- 1
Building PC Fee:
$190.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
$6.00
Building Overtime PC Fee:
$0.00
Planning Counter Review:
$0.00
Building Exertion 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 :
$421.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$421.00
PROCESSED BY:
OTHER DEPARTMENT:
ZONING APPROVAL:
PLAN CHECKED BY::
FIRE APPROVAL:
APPROVAL TO ISSUE:
.�
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALIE) INSPECTION - _ -- ----- -- 1
DECLARATION
I hereby afflraaunder penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item (a)
ction 7031.,5, gySiness and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
permit to file a ligned statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
2$sions °ode) orthat 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
ore than five Hundred dollars ($500).
� Ss owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
iness and.F9Msions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
rorements AreRfbt intended or offered for sale. If, however, the building or improvement issoldwithin one year of completion, the-Owner-Builderwill have the burden of proving that it was not built or
t$ved for the u.urpose of sale).
'I* as ownerof 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
t)I'to an owne$ of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
ain exem.;t frorp•licensure under the Contractors' State
Sy my Signature oeiovi I acknowledge that, except for my pet
0 Ti -structure that.1"ve built as an owner -builder if it has r
Irefessions Code,, is available upon request w 's app ]c
signature of Property Owner or Authorized Age
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed uni
nd effect.
icense Class License No
COMPENSATION DECLARATION
the following reason:
in whic uat have resided for at least one year prior to completion of the improvements covered by this permit, I cannot lega'.
:ted entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
d t e fol owing Web site:http://www.leginfo.ca.gov/calaw.htmi. p/' /Q
Da
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
Date
Contractor Signature
/ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), 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 th
Prmance of the work for which this permit is issued. Policy No.
ave 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
nce carrier and policy number are:
:arrier:rj,�5. C(J . 61- 4L, d Policy Number �� SO`t+1 7 r Expiration Date
lame of Agent Phone #
]I certify that, in the performanc o e ork for w Is 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 agrel
iat, if I should beco a subjec a kers' c sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those,provisionsL //
ignature of Applican Dat % / 9 /1%
DECLARATION REGA TRU T DING AGENCY N
hereby affirm under p 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).
Ender's Name Lender's Address
y 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 provi is correct.
I agree to comply with all applicable city and county or es and stat s relating to building construction.
I authorize representatives of this city or cou y to a ove;00,11fied property for inspection purposes. Q
nature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Name v Da
1/7
ACTION DATE BY DECLARATION OFCOMPLIANCEWTH CODE OF FOR OFFICE USE ONLY
FEDERAL REGULATJONSPART 6f OF TITLE40AND
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