HomeMy WebLinkAboutF2019-0604 - Permits"'t'�e City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2019-0604
°`' 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 9 0 6 0 4 Project No: 2468-2019
!, °''`r. Permit Counter Phone (949)644-3288
if
��tnradr:. Inspection Requests Phone (949)644-3255
Job Address: 101 NEWPORT CENTER DR NB Description: COMM - REPIPE EXTG HOOD SYSTEM "SESSIONS WEST COAST DELI"
2466-2019
Inspector Area: FIRE
Owner: IRVINE CO
Address: 550 NEWPORT CENTER DR
NEWPORT BEACH, CA 92660
Phone
Applicant:
HENDRICK RICHARD
Address:
13309 CENTRAL AVE
Address:
CHINO CA 91710
Phone:
951.515-7866
Code Edit: 2016
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
Construction Valuation
I -A -SPR
A21B
0
0
Legal Description:
N TR 6015 LOT 13
Contractor:
HEDRICK FIRE PROTECTION
Address:
13309 CENTRAL AVE
CHINO CA 91710
Phone:
909-613-0083
Con State Cie:
925132
Lic Expire:
11130/2020
Bus Lic:
BT30046669
Lic Exp Date:
03131/2020
Worker's Compensation Insurance
Carrier:
WESCO INS
Policy No:
SWC1237882
Expire:
04116/2020
3 Issued Date: 11/2212019
0 Setback- Front:
Rear:
Y Left:
Right:
Building PC Fee:
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Fee
Fire Plan Check Fee:
Fire Permit Fee :
Building Permit Fee:
TOTALFEE
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
$2,400.00
$0.00
$0.00
$0.00
$0.00
$136.00
$220.00
$0.00
$358.00
FEES
Fire Residential Alarm PC Fee
Planning Counter Review:
Planning Zoning PC Fee:
Public Works PC Fee:
Public Works Traffic Plan Check Fee;
Plan Check Fee :
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
$0.00
$0.00
$0.00
$0.00
$0.00
$136.00
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
INSPECTOR
State Lic:
State Lic:
HENDRICK RICHARD
13309 CENTRAL AVE
CHINO CA 91710
Records Management
Fee Due at Permit Issuance
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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$2.00
$0.00
$0.00
$222.00
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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 applicablip 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 ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ lam exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the.Bu 'fiess and Profes$jDR o a my license is in full force
and effect. ..... --
;oerweLlass _ _ License No D Contractor ignature
NORKERS' C(50IIMSATION DECLARATION ✓ 1
WARNING, FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO E HUN D THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
!OSTO4 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
,%el%affirm Br d. r p onalty of perjury one of the following declarations:
I VBVe and v II rWtain 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 thi
lVitence of1t13e *oT, for which this permit is issued. Policy No.
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'
-Barrier and pplicy number are:
. .": Policy Number Expiration Date
ie of Agent .. . Phone #
certify that, ill tlfd'performance of the work Ich this p rmit is issued, I shall not employ any person in any manner so as to become sut
if I shoull�become subject to the o��as Pion ;revisions of Section 3700 of the Labor Code, I shall forthwith comply with those
to the workers' compensation laws of California, and
DECLARATION"REGARDING qPKSTRWTION LENDING AGENCY (,ii / r
I hereby affirm under penal!)�efperjuroat 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. 1, f3 H r' / NG -ti.
I agree to comply with all applicable city and Count s a tate laws relating to building construction. �,
I authorize representatives of this city or county to'en a ve d ntified property for inspection purposes.
Signature of Property Owner or MQT5FEN Agent Print Property Owner's or Authorized Aggnt's Name
ACTION DATE BY
DECLARATION OF COMPLIANCE 14ITHCODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQMD RULE 1403.
PERMITEXPI RED
1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMITEKTENDED
POPOSEDDEMOLI ASBESTOS O RON1SNOTAPPLtCABLETO
PERMITFINAL -a OvZVZA
CERTIFICATE OF
OCCUPANCYISSUED
SIGNATURE:
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