HomeMy WebLinkAboutF2020-0022 - Permits�ycvt j4�y City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2020-0022
a,, 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 0 0 0 2 2 Project No : 0108-2020
E~ : _., ,'+,i. Permit Counter Phone (949)644-3288
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`r'x�,��yx^ Inspection Requests Phone (949)644-3255
Job Address: 4818 CORTLAND DR NB
Description: SFR FIRE SPRINKLERS X2019-1628 (28 HEADS)
Inspector Area: 5
Legal Description:
N TR 3519 LOT 16
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INSPECTOR
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Owner: STELLAR JOHN
Contractor:
FIREPROOF FIRE PROTECTION
Architect:
i �
L
Address: 265 BEVERLY ST
Address:
1101 KINGSTON DR
Address:
LAGUNA BEACH CA 92651
LA HABRA CA 90631
Phone:
Phone:
714-476-5370
Phone:
State Lie:
Applicant: FIREPROOF FIRE PROTECTION
Con State Lie:
876004
Engineer:
Address: 1101 KINGSTON DR
Lie Expire:
04/30/2020
Address:
LA HABRA CA 90631
Bus Lie:
BT30040107
Phone: 714-476-5370
Lie Exp Date:
07131/2020
Phone:
State Lie:
Code Edit: 2016
Worker's Compensation
Insurance
Designer:
CASEY MONTY
Type of Construction: V -B -SPR
Carrier:
NORGUARD INS CO
Address:
1101 KINGSTON DR
° ° ° °
o °
Occupancy Group: R3IU
Policy No:
MOWC002750
LA HABRA CA 90631
....
Added /New sq.ft. Bldg: 0
Expire:
02/15/2020
Phone:
Added/New sq. ft. Garage: 0
No of Stories: 2
Issued
Date:
Special Conditions:
No of Units: 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: Y
Left:
Right:
9
o a c oom 1) 11
co c
FEES°°o0
°° ° °
Construction Valuation: $2,800.00
°
°
c°
Building PC Fee :
$202.00
Fire Residential Alarm PC Fee : $0.00
Records Management:
° ° ° ° °.$6.00
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 :
$0.00
Public Works Traffic Plan Check Fee; $0.00
Building Permit Fee :
$240.00
TOTAL FEE :
$448.00
Plan Check Fee : $0.00
Fee Due at Permit Issuance :
$448.00
PROCESSED BY: vw�-
OTHER DEPARTMENT:
ZONING APPROVAL:
PLAN CHECKED BY::
FIRE APPROVAL:
_
APPROVAL TO ISSUE:
I
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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
1e 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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).
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:
',y 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
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.gov/calaw.htmi.
ignature 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 theess and Professions Code, and my Iicens i full force
nd effect.
icense Class License No \ Contracto nature
YORKERS' 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 HUNDRED THOUSAND DOLLARS 1810 ,IN ADDITION TO THE
OST OF COMPENSAVIONMAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
iareWy affirm under jenalty of perjury one of the following declarations:
1.1 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 th,
OrrrpBce of the Mork for which this permit is issued. Policy No. _.
have and will inairitain 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' compensatior
i$ur%%L? carrier and policy number are:
arriea. :*: 0. Policy Number Expiration Date
of
in % e peEormance of the work for win
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
be co je he workers' compensatio provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions.
�nlinanY Ql � Data_
CCARATION AEGARbING CONSTRUCTIONING AGENCY r'
�reby affirm under penalty of perjury that there iy�,�onstruction 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 countyd#onteLthgiove-identified propelr,y- inspection purposes. f.
nature of Property Owner or Authorize
Print Property Owner's or Authorized A ent's am
LAR TION OF COMPLIANCE MTH CODE OF
ACTION DATE BY
FOR
FE L REGULATIONS PART 61 OFTITLE40AND
OLE 1403.
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
- V
PERMITEXPIRED
PERMITCANCEIEED
PERMIT EXTENDED
ASBESTOS RONiS NOT APPLiCABL.E TO
PROPOSED DEMOLITION.
PERMIT FINAL
CER77FICATEOF
SIGNATURE:
OCCUPANCYISSUED
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