HomeMy WebLinkAboutF2019-0071 - Permits1uha City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 9 0 0 7 1
Permit Counter Phone (949)644-3288
FIRE Permit: F2019-0071
Project No : 0287-2019
Inspection Requests Phone (949)644-3255
Job Address: 204 COLLINS AVE NB
$0.00
Description: SFR FIRE SPRINKLERS (X2017-1150) 24 HEADS
Inspector Area: 2
Legal Description:
BALBOA ISLAND SEC 2 BILK 11 LOT 16
-
Owner: TRIMAR PROPERTIES
Contractor:
FIREPROOF FIRE PROTECTION
Architect:..
- Address:: 204 COLLINS AVE
Address:
1101 KINGSTON DR
Address:
NEWPORT BEACH 92661
$0.00
LA HABRA CA 90631
-'
Phone,
Phone:
714-476-5370
Phone: State Lie:
Applicant: CASEY MONTY
Con State Lie:
876004
Engineer:
Address: 1101 KINGSTON DR
Lie Expire:
04/30/2020
Address:.
LA HABRA CA 90631
Bus Lie:
BT30040107
Phone:
Lie Exp Date:
0813112019
Phone: State Lie:
Coge Edit : 2016
Worker's Compensation
Insurance
Designer: CASEY MONTY
T%pe of Ggnstrucdio&o ° o V -B -SPR
Carrier:
NORGUARD INS CO
Address: 1101 KINGSTON DR
Oc°cu°p"aAuy Group:' ° R3/U
Policy No:
MOWC901180
LA HABRA CA 90631
A`ddpd /New sq.t .°Bldg: c 0
Expire:
02115/2019.
Phone:
FPoi WVkew sq. & boAge:.. 0
No of Stories: 2
Issued Date: 0210512019
Special Conditions:.
NomdkjFlits: = „ 0
Setback -Front:
�Floogl,7one.. a ° o o
Rear:
'QIBg Sprinklers:° Y
Left:.
,
c, ° o
Right:
ca
FEES
Fire Residential Alarm PC Fee :
$0.00
Planning Counter Review:
C�nstrudion Vale°cation:
$2,400.00
$0.00
Building 9C Fee'
$202.00
Public Works Traffic Plan Check Fee;
Buildingvehrime PC Fee.
$0.00
$0.00
Building Extention Fee :
$0.00
Building Investigation Fee:
$0.00
Fire Plan Check Fee:
$0.00
Fire Permit Fee :
$0.00
Building Permit Fee :
$240.00
TOTAL FEE :
$446.00
FEES
Fire Residential Alarm PC Fee :
$0.00
Planning Counter Review:
$0.00
Planning Zoning PC Fee :
$0.00
Public Works PC Fee:
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Plan Check Fee:
$0.00
Records Management
Fee Due at Permit Issuance :
PROCESSED BY: �0� OTHER DEPARTMENT:
ZONING APPROVAL: CSA PLAN CHECKED BY::
FIRE APPROVAL: ' v_` APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
$4.00
$0.00
$0.00
$446.00''..
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
ie 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
'rofessions 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
of more than five hundred dollars ($500).
3 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,
lusiness 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
nprovements 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
nproved for the purpose of sale).
1 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
pply 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
lymy 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 legallt
ell 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 copyof the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calow.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED 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 Business and Professions Code, and my license is in full force
nd effect. t
icense Class License No Dat Contractor Signa
IIORKERS' COMPENSATION DECLARATION V
'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 ($1V,0%0), Ir#ADDITI(* To THPO
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. • • • , • • n o
hereby affirm under penalty of perjury one of the following declarations:
000
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 tfle Labor Code; Sor th'
Ar"anGe 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 Wor�C%.compenoaatior
nce carrier and policy number are:0 0
••••
Policy Number
of Agent
Date
_ o
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 subject to the workers' compensation laws of•Califpcnia, and al
if I should become sybjeg tt`he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. • • ,• p
nature of Applicant v�L u d •"-
CLARATION REGA G CONSTRUC ENDING AGENCY • • • ••
:reby 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).
ider's Name Lender's Address
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 and state laws relating to building construction.
I authorize representatives of this city or count a above -identified property for inspection purposes.
nature of Prooertv Owner or Authorized AC' roperty Owner's or Authorized Agent's Nam iii� C�-�C�t DateG�
AC17ON DATE BY
uCLLA1 trrrury ur wmruAvur wrfn usucur
- run urriLr use U/YLr
FEDERAL REGULATIONSPART61 OFTITLE40AIVD
AQMD RULE 1403.
PERMITEXPIRED
❑ t SUBMITTED ASBESTOS NODFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLEO
PERMITEXTENDED
❑ ASBESTOS MORFICADONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PEWIT FINAL
CERURCATEOF
SIGNATURE:
OCCUPANCYISSUED
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