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Home My WebLink AboutF2020-0447 - PermitsN City of Newport Beach - Building Division I II 100 Civic Center Drive, Newport Beach, CA 92660 P IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIIII Permit Counter Phone (949)644-3288 Job Address: 2300 BONITA CANYON OR NB Inspector Area: FIRE Owner: CHURCH TEMPLE CORP Address: 50 E NORTH TEMPLE #2223 SALT LAKE CITY, UT 84150 Phone: Applicant: CORNWALL KENT Address: 234 N MELINE AVE Occupancy Group: PASADENA CA 91101 Phone: 626-793-5782 Code Edit: 2019 P M 271.15 PAR 1 FOR OF PAR Type of Construction: II -B -SPR Occupancy Group: B Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Flood Zone: X Bldg Sprinklers: Y FIRE Permit: F2020-0447 Project No: 2043-2020 Inspection Requests Phone (949)644-3255 Description: COMM FIRE ALARM (13) DEVICES (X2020-1845) Legal Description: P M 271.15 PAR 1 FOR OF PAR Contractor: SYNERGISTIC MATRIX INC _Address: 17881 FELSON CIRCLE HUNTINGTON BEACH CA 92649 Phone: 714-473-0310 Con State Lie: 932590 Lie Expire: 0513112021 Bus Lie: BT30073417 Lie Exp Date: 10131/2021 Worker's Compensation Insurance Carrier: NO EMPLOYEES Policy No: CORNWALL KENT Expire: Address: Issued Date: 11/05/2020 Setback- Front: $0.00 Rear: $270.25 Left: 626-793-5782 Right: $0.00 Architect: Address: zP� Phone: State Lie: 4d / Building PC Fee : Engineer: Fire Residential Alarm PC Fee : $0.00 Records Management : - $2.00 Address: $0.00 M Phone: State Lia $0.00 Planning Zoning PC Fee : $0.00 Building Investigation Fee: Designer: CORNWALL KENT $0.00 Address: 234 N MALINO AVE Public Works PC Fee: $0.00 $0.00 PASADENA CA 91101 $270.25 Phone: 626-793-5782 0 Special Conditions: FEES Construction Valuation: $1,732.00 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: $189.25 Public Works PC Fee: $0.00 $0.00 Fire Permit Fee: $270.25 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $0.00 TOTAL FEE : $461. Plan Check Fee: $0.00 Fee Due at Permit Issuance: $461.50 PROCESSED BY: QTHER DEPARTMENT: ZONING APPROVAL: 0 000 0 o iPLAN CHECKED BY:: 0 c< < c 00 FIRE APPROVAL: APPROVAL TO ISSUE: PERMIT EXPIRES, 960 PA YSARTE-716SU'INCE OR LAST VALID INSPECTION °�� 00o c o 00 00 ooe DWNER-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) 1 have placed next to the applicableitem(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). 11I, 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 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.htmi. 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 Busin s and P ons e , and my licens is in full force and effect. License Class License No Date — — 20 Contractor Sign atur WORKERS' COMPENSATION DECLARATION WARNING: 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 37DO OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 the performance of the work for which this permit is issued. Policy No. 131 have 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' compensatior insurance carrier and policy number are: of Agent if I Policy Number Date in the perfo mance of tpewo hic issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and 3ecome s ct to t vers' pensation rovlsi sof Section 3700 of the Labor Code, I shall forthwith comply with those prove nature of ApplicantN L"J�--�-'— CLARATION REGA D ONST CTIOENDING 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 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 p e ' rrec I agree to comply with all applicable city and ounty din es a ate laws rel Ing to building construction. I authorize representatives of this city or cou hh a -i tilled rty for inspection purposes. mature of Pmnertv Owner or Authorized Alien '/ Print Property Owner's or Authorized Agent's Nam ACTION DATE BY �v11 u. --,. .. -- FEDERAL REGUTATIONSPART 67 Of TITLE40 AND PERMIT EXPIRED AWD RUlE 4487. ❑ ISUB11iTTELjASBE-4TOSM611FICVWNTO PERMITCANCELLED ❑•%A • • • •• PERMfFEXFENDED 13AQMpi • • • • i i i _ ❑ ASBESTOS No nnCA nok &NOT APPLIOIBLE TO PERMIT FINAL f,9 ' %O PROPOSED DEMOLITION. CERTIF/CATEOF SIGNATURE: •i• '•� •�• •�. ••• ••� OCCUPANCYISSUED Civil Code). , YPe5•�7