HomeMy WebLinkAboutF2020-0296 - PermitsCity of Newport Beach - Building Division *F2020-0296* FIRE Permit: F2020-0296
100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1238-2020
E Permit Counter Phone (949)644-3288
�. 4+
Inspection Requests Phone (949)644-3255
Job Address: 610 NEWPORT CENTER DR NB St: 1 FI:
13
Description: COMM FIRE ALARM TI (X2020.0561)'CHIPOTLE' CORP OFFICE. 46
Inspector Area: FIRE
Legal Description:
P BK 295 PG 33 PAR 4
$16,622.00
Owner:
COSTELLO JAMES W
Contractor:
BUILDING ELECTRONIC CONTROLS
Architect:
A 111'''1111 �1
I'i1 � � Fes! -.TO R
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Address:
660 NEWPORT CENTER DR
Address:
2246 LINDSAY WAY
Address:
V VVV 1
Building Extention Fee :
NEWPORT BEACH, CA 92660
Planning Zoning PC Fee: -
GLENDORA CA 91740
Building Investigation Fee :
Phone:
Phone:
808-305-1600
Phone:
State Lic:
. Applicant:
BALTAZAR ARI
Con State Lic:
729905
Engineer:
Public Works Traffic Plan Check Fee;
Address:
2246 LINDSAY WY
-Lic Expire:
11130/2020
Address:
GLENDORA CA 91740
Bus Lic:
BTS7025666
$641.50 Fee Due at Permit Issuance :
$0.00
Phone:
909-305-1600
Lic Exp Date:
1013112020
Phone:
State Lic:
Code Edit: 2019 Worker's Compensation Insurance Designer: BALTAZAR ARI
Type of Construction: I -A -SPR Carrier: ZURICH AMERICAN Address: 2246 LINDSAY WY
Occupancy Group: B Policy No: GLENDORA CA 91740
Added /New sq.ft. Bldg: 0 Expire: 0410112021 Phone: 909-305-1601) - '--
Added /New sq. ft. Garage: 0
No of Stories: - 78 Issued Date: 0611812020 Special Conditions: i DUPLICATE
No of Units : 0 Setback- Front:
Flood Zone: X Rear:
Bldg Sprinklers: Y Left:
Right: F
.. PROCESSED BY:
ZONING APPROVAL:
FIREAPPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$16,622.00
Building PC Fee:
$0.00
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:
$261.25
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$374.25
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTAL FEE :
$641.50
Plan Check Fee:
$641.50 Fee Due at Permit Issuance :
$0.00
.. PROCESSED BY:
ZONING APPROVAL:
FIREAPPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
DECLARA
1 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do t_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
iusiness 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
Jonly 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:
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 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:hltp://w .leginfo.ca.gov/calaw.html.
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 Professions Code, and my license is in full force
nd effect.
icense Class License No Date Contractor Signature
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 HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 9708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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
erformance of the workfor which this permit is issued. Policy No.
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'
rance carrier and policy number are:
Policy Number
of Agent
Date
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 the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
mature of Applicant Date
CLARATION REGARDING CONSTRUCTION LENDING 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, 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 owners 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 to enter the above -identified property for inspection purposes.
mature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name
ACTION DATE By
DECLARATION OF COMPLIANCE MTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 67 OFTIIL€40AND
AQMD RULE 7407.
PERMIT EXPIRED
❑ I SUBMITTEDASBESTOS ROTIF/CATION TO.
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED -
❑ ASBESTOS NORFICAIIONIS NOTAPPLICABL€TO
PROPOSED DEMOLITION.
PERMITFINAL sG O
CERTIFICATEOF
SIGNATURE.,
OCCUPANCYISSUED