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Home My WebLink AboutF2020-0049 - Permitsy1b'tr�fi City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 k r''°triitr�!`p Job Address: 4242 CAMPUS DR NB Inspector Area: FIRE Owner: BEACHWOOD PROPERTIES LLC Address: 1600 DOVE ST #107 NEWPORT BEACH CA 92660 Phone: Applicant: SILLS ROBERT Address: 9595 LUCAS RANCH RD # 100 Phone: RANCHO CUCAMONGA, CA 91730 Phone: 888-972.7581 Code Edit: 2019 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: VB U 0 0 II IIS II ILII VIII ILII VIII 111111 SII VIII VIII III II FIRE Permit: F2020-0049 Project No: 2748-2019 Inspection Requests Phone (949)644-3255 r Description: COMM INSTALL 250 GALLON ABOVE GROUND FUEL TANK (X2019-3993) Legal Description: TR. 3201 LOT 25 AND LOT 26 Contractor: JONES COVEY GROUP INCORP. Address: 9595 LUCAS RANCH RD #100 RANCHO CUCAMONGA CA 91730 Phone: 888-972-7581 Con State Lie: 804431 Lie Expire: 08/31/2021 Bus Lie: BT30070218 Lie Exp Date: 12/31/2020 Worker's Compensation Insurance Carrier: EVEREST NAT'L INS CO Policy No: CA100002046191 Expire: 0510112020 0 Issued Date: 0113112020 0 Setback- Front: X Rear: N Left: Right: cc Architect: Address: 0 Phone: State Lic: Engineer: LU Address: Phone: State Lie: fd"1 Designer:) $0.00 Records Management: Address: Building Overtime PC Fee: Phone: Planning Counter Review: Special Conditions: • •o• • ••• •• PROCESSED BY: C •_m e • o o •OT•HCR9EPARTMENT: o • m • • 0 0 ZONING APPROVAL: ° ° ° ° m o °PL°AN 01ECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: t� oem a • • o•• o• - o m m o 0 e e PERMIT EXPIRES 180EDAtS AFI -ER 1�'S✓e!ANVE qR tAST VALID INSPECTION •o° on •° o m oeo 00 FEES Construction Valuation: $3,000.00 Building PC Fee: $0.00 Fire Residential Alarm PC Fee: $0.00 Records Management: $0.00 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: $0.00 Public Works PC Fee: $0.00 $0.00 Fire Permit Fee : $407.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $0.00 TOTAL FEE : $407.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $407.00 • •o• • ••• •• PROCESSED BY: C •_m e • o o •OT•HCR9EPARTMENT: o • m • • 0 0 ZONING APPROVAL: ° ° ° ° m o °PL°AN 01ECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: t� oem a • • o•• o• - o m m o 0 e e PERMIT EXPIRES 180EDAtS AFI -ER 1�'S✓e!ANVE qR tAST VALID INSPECTION •o° on •° o m oeo 00 IWNER-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) lection 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 is 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). 1 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, ',usiness 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, 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legal 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 copy of 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.govicalaw.htm]. ',ignature of Property Owner or Authorized Agent Da .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 Pro sio n my license is in full force nd effect. icense Class License No Dat r Contractor Signatur VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREO�rH0U5AN0 DOLLARS ($760,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, hereby affirm under penalty of perjury one of the following declarations: have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for rmance of the work for which this permit is issued. Policy No. have and will MaiSin workers' rance carrier 30'cy number ne of Agent cT6.Sr- certify that, in the performance if I should become�jUbb�'�ct t iature of Applicant _/\ Z7 insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Date this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p visions. N a_ '21 n,r _ hereby affirm under penalty of peuiury that there is a construction lending agency for the performance of the work for which this permit is Ender's Name ��jj Lender's Address y my signature below, I certify to ach of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have prov Yed is correct. I agree to comply with all applicable city and county ordi 4 -es and state laws relating to building construction. I authorize representatives of this city or county to/�nte th ly identified property for inspection purposes. ianature of Pfopertv Owner or Authorized Agent �/ L Print Property Owner's or Authorized Agen ACTION DATE ( BY vrirnuini , FEj3Ei—f,GUMOIji3QARTtilOF.ftV40AND PERMITEXPIRED A RU1, 1403. ❑• f$t.ihifTMEO.$SBEM9NOjtFIt r1710N TO: PERMITCANCELLED £PA PERMITEXTENDED ❑ AQMD ❑ ASBESTOS NOBFICAVON/S NOT APPLICABLE TO PERMITFINAL 2, PR0MSI'CVEJMJJT401J. •*. ':' CERTfFtCATEOF ' .' e OCCUPANCYtSSUED SIGNATGR�: : : •*. :0 (Section 3097, Civil Code). RRM#711141 -3/: