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HomeMy WebLinkAboutF2021-0173 - PermitsCity of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Ly. " 100 Civic Center Drive, Newport Beach, CA 92660 2 0 2 1 0 1 7 3 Permit Counter Phone (949)644-3288 eyQrrrara"�`1` FIRE Permit: F2021-0173 Project No : 0996-2021 Inspection Requests Phone (949)644-3255 Job Address: 520 NEWPORT CENTER DR NB St: 1 FI: 7 Unit: 750 Description: COMM FIRE ALARMS 6 DEVICES (X2021.1076) Inspector Area: FIRE Legal Description Owner: IRVINE CO Contractor: SIMPSON DAVID CONST CO INC Architect: Address: 111 INNOVATION DR Address: 17177 GILLETTE AVE #A Address: IRVINE, CA 92617 IRVINE CA 92614 $0.00 Phone: 949-720-2400 Phone: 949.250-1348 Phone: Applicant: YAM MARK Con State Lie: 381149 Engineer: Address: 392 LEMAY CT Lie Expire: 03/31/2023 Address: ORANGE, CA 92867 Bus Lic: BT00006013 Phone: 626-757-2320 Lie Exp Date: 06/30/2021 Phone: Code Edit: 2019 Worker's Compensation Insurance Designer: Type of Construction: I -A -SPR Carrier: CYPRESS INSURANCE CO Address: Occupancy Group: B Policy No: DAWCC222034 Added/New sq.ft. Bldg: 0 -Expire: -05/0112022 - - - Phone: Added /New sq. ft. Garage: 0 $173.50 Fee Due at Permit Issuance : $251.50 No of Stories: 21 Issued Date: 06/1412021 Special Conditions: No of Units : 0 Setback- Front: Flood Zone: X Rear: Bldg Sprinklers: Y Left: Right: State Lie: - 1 State Lie: IM TAYLOR RICK 2246 LINDSAY WAY GLENDORA, CA 91740 _ 909.305-1603 PROCESSED BY: pO° ° � .®4)THE�DEPAqTMENT: ° ZONING APPROVAL: _ � �° , ° O -?LAN C`K�--dKdO BY:: FIRE APPROVAL: ` APPROVAL TO ISSUE: ° po0 BG ®4'J PERMIT EXPIRES 180 DAYS -AFTER 1SS`JJANCE O!2 LA4T VALID INSPECTION u �°O °°O O P 6• •• •i• FEES Construction Valuation: $1,496.00 Building PC Fee : $0.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $4.00 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: $173.50 Public Works PC Fee: $0.00 $0.00 Fire Permit Fee : $247.50 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $0.00 TOTAL FEE : $425.00 Plan Check Fee : $173.50 Fee Due at Permit Issuance : $251.50 PROCESSED BY: pO° ° � .®4)THE�DEPAqTMENT: ° ZONING APPROVAL: _ � �° , ° O -?LAN C`K�--dKdO BY:: FIRE APPROVAL: ` APPROVAL TO ISSUE: ° po0 BG ®4'J PERMIT EXPIRES 180 DAYS -AFTER 1SS`JJANCE O!2 LA4T VALID INSPECTION u �°O °°O O P 6• •• •i• 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) 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 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 improved 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 legal]) 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.html. Signature of Property Owner or Authorized Agent D to 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 Business and Professio ode, and n e i in full force and effect. License Class License No Date , v Contractor Sign re WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 00, 0), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 th( ffp�gg1Irf'ormance of the work for which this permit is issued. Policy No. yhave and wit 'r workers' compensation insurance, as re wired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior Ifni-isurance carrier a glicy numberj� Carrier O�Rc� u i Expiration Date Name of Agent Phone # s ❑1 certify that, in the perfonnance f e work for hick th s p- -mit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become s ject to t wor ers' co pensat o r/ visions o ec lo 700 of the Labor Code, I shall forthwith comply with those provisions 1 Signature of Applicant P v D TeN DECLARATION REG G N UCTION LEN6196 AGENCY ' - f th t thtruction lendin a an for the performance of the work for which this permit is issued (Section 3097, Civil Code). _ Treby affirm under enalty o pequry a ere Is a cons g g Iy Ider's Name Lender's Address my signature below, 1 certify to each of the following: I am the property owner or authorized to act on the property owni behalf. I have read this application and the information I have provi ed s correct. . I agree to comply with all applicable city and county ordina c and state s atin to building construction. I authorize representatives of this city or county Idente bove-identif d prope for inspection purposes. nature of Pmnertv Owner or Authorized AGenk / Print Property Owner's or Authorized Agent's Name ACTION I DATE F � BY 1 PERMIT EXPIRED I I H I PERMIT CANCELLED I 1 /11 :.s s? >PART 61 OF T1TLE40AND Yg5 1,tWFICARON TO:: renmrr th rcrvvEu A58ESTOSN CATIONS OT APPL E PERMIT FINAL O�.SEDDD ION. CERTIFICATEOF SttiN • :s� is / OCCUPANCYISSUED • s 1 FOR