HomeMy WebLinkAboutF2019-0523 - PermitsCity of Newport Beach - Building Division l�ll�illillillillillillilliillillillillillillilliilillilljlI
100 Civic Center Drive, Newport Beach, CA 92660 - F 2 0 1 9 0 5 2 3
Permit Counter Phone (949)644-3288
Job Address: 13 CORPORATE PLZ NB
Inspector Area: FIRE
Owner: CHICOASSOCIATES INC
Address:' 17 CORPORATE PLAZA DR
NEWPORT BEACH, CA 92660
Phone:
Applicant: DURANDCRAIG
Address: 7602 ANTHONY AVE
GARDEN GROVE CA 92841
Phone: 714-460-0101
Code Edit: 2016
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Flood Zone:
Bldg Sprinklers: N
Construction Valuation:
Building PC Fee:
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Fee
Fire Plan Check Fee:
Fire Permit Fee :
Building Permit Fee
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
$15,000.00
FIRE Permit: F2019-0523
Project No : 2072-2019
Inspection Requests Phone (949)644-3255
$0.00
$0.00.
$0.00
$0.00
$187.00
$314.00
$0.00
$544.25
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:
$0.00 Records Management
$0.00
$0.00
$41.25
$0.00
$0.00 Fee Due at Permit Issuance
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
$2.00
$0.00
$0.00
$544.25
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Description: COMM -. REPL
2072-2019
UNDERGROUND FIRE LINE
I � ��]�f iJ _T1.0 �
Legal Description:
P BK 93 PG 45 PAR 13
(—
Contractor:
ACTION FIRE PROTECTION
Architect:
Address:
7602 ANTHONY AVE
Address:
GARDEN GROVE CA 92841
Phone:
714-260-0101.
Phone:
State Lic: •....
Con State Lica
848831
Engineer.
Lic Expire:
10/31/2020
Address:
® ° ° ® • • ° c o c
Bus Lic:
BT30068350
Lic Exp Date:
08/3112020
Phone:
State Lic:
Worker's Compensation Insurance
Designer:
...... °
Carrier:
OAK RIVER INSURANCE
Address:
^•
.Policy No:
DUWC016120
.°° o
Expire:
06120/2020
Phone:
t E'O°OC
Issued Date: 0911712019
Special Conditions:
Setback- Front:
Rear.
Left:
Right:
$0.00
$0.00.
$0.00
$0.00
$187.00
$314.00
$0.00
$544.25
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:
$0.00 Records Management
$0.00
$0.00
$41.25
$0.00
$0.00 Fee Due at Permit Issuance
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
$2.00
$0.00
$0.00
$544.25
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
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 legall,
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 Qpkle!is available upon request when this application is submitted or at the following Web site:hltp://www.leginfo.ca.gov/calaw.html.
Signature of4jppt3jty Owner or Authorized Agent Date
LICENSED (;QNTRACTOR'S DECLARATION
IMeieby affirmnarlpgf 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
and jeffect. —f
License Class ' License No Date '� l� Contractor Signat
llVORKERS'.ftMjENSATION DECLARATION
NAffjjrq ITG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR O DOLLARS ($100,000), IN ADDITION TO THE
CO$r OF COMPBIISJ7 &T, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
'ITeTaby affirAinder penalty of perjury one of the following declarations:
(Igve 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
1 ''ante of 47g,Hwack for which this permit is issued. Policy No.
and will maigtain 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' compensatio
nsu pee carrier and policy number are:
.arner Policy Number Expiration Date
of Agent
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 California, and
if I should become subject to tlD"orkers' compensaljg_n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions._
of
3reby affirm under penalty ofp rju th�Alybre is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
7der'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 county e/��wc�the above -id tified property for inspection purposes. C
nature of Prooertv Owner or Authorized ADe� l-•"/1�..- Print Prooertv Owner's or Authorized Aaent's Nam%J Okw(,
ACTION I DATE
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