HomeMy WebLinkAboutF2021-0210 - Permits�,»�t�, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2021-0210
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 2 1 0 Project No: 1186-2021
Permit Counter Phone (949)644-3288 )
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r5t�.t,,v+'' Inspection Requests Phone (949)644-3255
Job Address: 33 SEA ISLAND DR NB Description: MFR FIRE SPRINKLERS 22 HEADS (X2021-0926)
Inspector Area: 4
Legal Description: TR 8444 LOT 1 UNIT 33 OF PROJECT LOCATED ON AP 442-251.01
TOGETHER
Construction Valuation:
$1,500.00
Owner: GRAY KELLY
Contractor:
FIREPROOF FIRE PROTECTION
Architect:
$217.00
Address: 330 SEA ISLAND DR
Address:
1101 KINGSTON DR
Address:
$0.00
NEWPORT BEACH, CA 92660
$0.00
LA HABRA CA 90631
Building Extention Fee :
$0.00
Phone:
Phone:
714-476-5370
Phone:
State Lic:
Applicant: CASEY MONTY
Con State Lic:
876004
Engineer:
$0.00
Address: 1101 KINGSTON DR
Lic Expire:
04/30/2022
Address:
$0.00
LA HABRA CA 90631
Bus Lic:
BT30040107
Building Permit Fee :
$263.00
Phone: 714476-5370
Lic Exp Date:
06/31/2021
Phone:
State Lic:
Code Edit : 2019
Worker's Compensation Insurance
Designer:
CASEY MONTY
Type of Construction: V -B -SPR
Carrier:
SECURITY NATIONAL INS
Address:
1101 KINGSTON DR
Occupancy Group: R2
Policy No:
SWC1326710
LA HABRA CA 90631
Added /New sq.ft. Bldg: 0
Expire:
02115/2022
Phone:
714-476-5370
Added /New sq. ft. Garage: 0
-
No of Stories: 2
Issued Date: 05126/2021
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
Right:
INSPE00' 10
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
09y�/ws rsm -
APPROVAL TO ISSUE:
2ERNA o EX0RES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$1,500.00
Building PC Fee:
$217.00
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:
$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 :
$263.00
TOTAL FEE :
$484.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$484.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
09y�/ws rsm -
APPROVAL TO ISSUE:
2ERNA o EX0RES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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).
❑ 1, 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 Business and Professions Code, and my license is in full force
and effect.
License Class License No Date S t ' ti k Contractor Signature
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 H 1DRED THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
IIhhrereby affirm under penalty of perjury one of the following declarations:
u 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 thI
i5grformance of the work for which this permit is issued. Policy No.
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'
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.
of
CLARATION RUA't2DING CONSTRUCTION LENDING AGENGY
;reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
lder'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 county to enter the above -identified property for inspection purposes.
nature of Pmnerty Owner or Authorized ADEN ✓ f _ "� Print Property Owner's or Authorized Agent
ACTION
PERMITEXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
DATE I BY
. -
(Section 3097, Civil Code).
FOR
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PROPOSFD DEMOLITION.
SIGNATURE.,
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