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HomeMy WebLinkAboutF2021-0182 - Permits'r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II e' 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 1 8 2 r. v. Permit Counter Phone (949)644-3288 FIRE Permit: F2021-0182 Project No: 1036-2021 Inspection Requests Phone (949)644-3255 Job Address: 4440 VON KARMAN AVE NB St: 1 FI: 2 Unit: 230 Description: COMM FIRE ALARM (15) DEVICES (X2020.2974) Inspector Area: FIRE Legal Description: N TR 8762 LOT 5 Owner: 4440 VKA TIC 3 LLC Contractor: VFS FIRE R SECURITY SVCS Architect: Address: 2 PARK PLZ #700 Address: 501 W SOUTHERN AVE Address: IRVINE CA 92614 Bus Lic: ORANGE CA 92865 Phone: Phone: 714-778.6070 Phone: Applicant: LOPEZ ARLYN LOPEZ ARLYN Con State Lic: 689284 Address: 501 W SOUTHERN AVE ORANGE CA 92865 Lic Expire: 05/31/2022 ORANGE CA 92665 Bus Lic: BT30075154 Phone: 714-778-6070 Lic Exp Date: 04/30/2022 Code Edit: 2019 Worker's Compensation Insurance Type of Construction: I -B -SPR Carrier: FEDERAL INS CO. Occupancy Group: B Policy No: 54309647 Added /New sq.ft. Bldg: 0 Expire: 03/31/2022 Added /New sq. ft. Garage: 0 No of Stories: 3 Issued Date: 05/11/2021 No of Units : 0 Setback- Front: Flood Zone: X Rear: Bldg Sprinklers: Y Left: Right: FEES Construction Valuation: $5,000.00 Building PC Fee : $0.00 Fire Residential Alarm PC Fee Building Overtime PC Fee: $0.00 Planning Counter Review: Building Extention Fee : $0.00 Planning Zoning PC Fee Building Investigation Fee: $0.00 Fire Plan Check Fee: $193.75 Public Works PC Fee Fire Permit Fee : $276.75 Public Works Traffic Plan Check Fee; Building Permit Fee : $0.00 TOTAL FEE : $476.50 Plan Check Fee Engineer: Address: Phone: State Lie: State Lic: Designer: LOPEZ ARLYN Address: 501 E SOUTHERN AVE ORANGE CA 92865 Phone: 714-778-6070 Special Conditions: eicei,�;1'6 1L4. Llq aC>�"1 $0.00 Records Management $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance PROCESSED BY: =IYV °rte •o• 000 •o° oe• °'QT[iE% DEPARTMENT: ° • o o ° ° ° 0 0 0• e c ZONING APPROVAL: ° ° 0 ° co `c© • PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: oc o00 0 • °•• PERMIT EXPIRE& 190 DFS FS e4FV-E)2FISS?JANCEOR LAST VALID INSPECTIOA o c o o 0 ° •• o00 • • •• •o° ••• $6.00 $0.00 $0.00 $476.50 z Co 0 Iii 0 i Q Do )WNER-BUILDER DECLARATION r 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). I, as owner of the property, or my employees with wages as their sole compensation, will do `) all of or (_) 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). 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). 1 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 Iega111 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. 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 Prof Bions Code and my license is in full force nd effect. 1 icense Class License No Date �9 Contractor Signatu IIORKERS' COMPENSATION DECLARATION DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T e NO DOLLARS ($700,000), 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: ] 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 erjormance of the work for which this permit is issued. Policy No. have and wil,'ai;in worker%;', mpensation insurances required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' rance carrier a d p licy numbA arpJ�.. P. 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 �su/sect to the workers' ompensa(tion� provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provlsiops. iature of ADDIICanf 7�� _ /1�'" R�L'� Dat-/ ' 5- 2 / hereby affirm under penalty of perjury that thfir 1e s a construction lending agency for the performance of the work for which this permit is issued ender's Name Lender's Address y 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 grdinances and s e law ale g to building construction. I authorize representatives of this city or county 4Q terttye 4ove-ide ifi y for inspection purposes. ACTION I DATE ir��v,�errxtcxL�I,7r,�� i PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED or Authorized Aaent's Name 76RAL BEGUL4TQQN5F,4RT61 OF TITLE40AND OD12ULEM403. • . • . :U&MIrFEDA&EESt0S�t MjCAPJONTO: J:&RA •• •; O` AQMD... IS NOT APPLICABLE TO ,I• •4 .ti 3097, Civil Code). FOR OFFICE USE ONLY > 8 O Y a V O U M 07 m O v O W p U BC\l C G (OD F C o N Z °o o LL y C T Z U LLJO O WW m N CO Ll U W w(D W O C a C O Y N = U Q y r a U) Z m O G >a Q Q m r V] L L>LI N co U aW. Z r Z O w y K c m U) OU) W Z N N w in U � O o d O M U O U '� N N N a) ,[; U U a c CiO yGy N cL U U l O U N y y W W LL p N Z J y 'yir am LL ~ y r o W uj} ie% Z % N U v C' m Z w U c U v. y ,, W ch (Dw a) Wc`4' W Z a IL. 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