HomeMy WebLinkAboutF2020-0029 - Permits�,��, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2020-0029
4 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 0 0 0 2 9
p Project No: 0136-2020
�, :; � Permit Counter Phone (949)644-3288
0°^rcrraw'�'' Inspection Requests Phone (949)644-3255
Job Address: 888 SAN CLEMENTE DR NB Srf, so*
Description: COMM FIRE SPRINKLER TI 6 HEADS (X2019.3920)
Inspector Area: FIRE
Legal Description:
IRVINE SUB. POR OF BLOCK 55.
$1,300.00
Owner: IRVINE COMPANY
Contractor:
FIRE PROT SPECIALISTS
Architect:
-
Address: 550 NEWPORT CENTER DR
Address:
2810 E MIRALOMA AVE
Address:
Planning Counter Review:
NEWPORT BEACH, CA 92660
ANAHEIM CA 92806
$0.00
Planning Zoning PC Fee:
Phone:
Phone:
714-635-6500
Phone:
State Lic:
Applicant: HERNANDEZ LUDVIN
Con State Lic:
464915
Engineer:
Public Works PC Fee:
Address: 2810 E MIRALOMA AV
Lic Expire:
10/31/2020
Address:
Public Works Traffic Plan Check Fee;
ANAHEIM CA 92806
Bus Lic:
BT30042894
$0.00 `
Phone:
Lic Exp Date:
0513112020
Phone:
State Lic:
Code Edit: 2016
Worker's Compensation Insurance
Designer:
HERNANDEZ LUDVIN
Type of Construction: V -B -SPR
Carrier:
COMP WEST INS. CO.
Address:
2810 E MIRALOMA AV
Occupancy Group: B
Policy No:
WCV6602952
ANAHEIM CA 92806
Added /New sq.ft. Bldg: 0
Expire:
12/02/2020
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 3
Issued Date: 01/21/2020
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: Y
Left:
Right:
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
oc� c
APPROVAL TO ISSUE:
E°
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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FEES
` Aper ECT
Construction Valuation:
$1,300.00
t L -
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:
$148.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit as :
$191.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00 `
TOTAL FEE :
$341.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance : $341.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
oc� c
APPROVAL TO ISSUE:
E°
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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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).
❑ 1, 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-havp;k1he burden of proving that it was not built or
im roved 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).
❑ 1 am 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://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professi o'e d my license is in full force
and effect.
License Class License No Da 256 Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: 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 ($700,000), IN ADDITION TO THE
COST 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:
❑ 1 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 thf
oo,ormance of the work 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'
carrier and policy number are:
is of Agent
certify that, in the performance of the work for
, if I should become subject tolthe workers' co
Policy Number Expiration Date
this permit is issued, I shall not employ any person in any manner so as to become subject to the
Alkhn-provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant I JL Date t �r
IECLARATION REGARDING ONSTRUCTION L NDI G GENCY
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).
Ender's Name Lender's Address
ly 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 with all applicable city and county ordinances a tate laws relating to building construction.
I authorize representatives of this city or county to enter the aboy property for inspection purposes. cj �9
linnahvB of Prnnwrfv Owner nr ADfi thnrizsd Aaent� Print Prooertv Owner's or Authorized Agent's Name J UI! (�d[/
laws of California, and
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