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Home My WebLink AboutF2020-0318 - PermitsCity of Newport Beach - Building Division *F2020-0318* FIRE Permit: F2020-0318 ur" 100 Civic Center Drive, Newport p Beach, CA 92660 Project No :1363-2020 Permit Counter Phone (949)644-3288 -F22-02-0 2 1 ` � 1 '6M ��-1— �aJ 6 Inspection Requests Phone (949)644-3255 Job Address: 500 E BALBOA BLVD NB Description: COMM - FIRE SPRINKLERIMIXED USE 90 HEADS: (X2020-0124) 1363-2020 Inspector Area: FIRE Legal Description: BALBOA 7R LOT 11 BLK 5(LOT 12 ELK 5 �� Owner: 500 EAST BALBOA LLC Contractor: FIREPROOF FIRE PROTECTION Architect: Address: 1203 BAY FRONT N Address: 1101 KINGSTON DR Address: NEWPORT BEACH, CA 92662 LA HABRA CA 90631 Phone: Phone: 714-476-5370 Phone: State Lic: Applicant: CASEY MONTY Con State Lic: 876004 Engineer: Address: 1101 KINGSTON DR Lic Expire: 04/3012022 Address: LA HABRA CA 90631 Bus Lic: BT30040107 Phone: 714476-5370 Lic Exp Date: 08/31/2021 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: FIREPROOF FIRE.....•.00 Type of Construction: V -B -SPR Carrier: NORGUARD INS CO Address: 1101 KINGSTON DR Occupancy Group: M/R2IU Policy No: MOWC148384 LA HABRA, CA 90631 • • ° ! Added /New sq.ft. Bldg: 0 Expire: 02/15/2021 Phone: Added /New sq. ft. Garage: 0 0 0 0 ° ° • �, No of Stories: 3 Issued Date: 10/2112020 Special Conditions: °. •, . , No of Units: 0 Setback- Front: • , • • �! Flood Zone: Rear: • ° Bldg Sprinklers: YLeft: Right: Q..... ®....a iO O U FEES 60 Construction Valuation: $8,000.00 Oq•TDU eoo. o • , • n ° Building PC Fee: $0.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $14.00 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: $457.00 Public Works PC Fee : $0.00 $0.00 Fire Permit as: $490.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee: $0.00 - TOTAL FEE : $961.00 Plan Check Fee: $457.00 Fee Due at Permit Issuance : $504.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: / PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION IWNER-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 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). 1, 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). 3 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 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' Stale 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 legally ell a structure that I have built as an owner -builder if it has not been constructed in its entirely 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 Professions Code, and my license is in full force is effect. ^ . nd eClass - License No Date 1 ° Contractor Signature VORKERS' COMPENSATION DECLARATION 6MI119:rFAILURE TO.SE6URE 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 bST OF QOMPENSAIIOII,J A.MAGES AS PROVIDED FOR IN SECTION 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. per eby affirm under penally of perjury one of the following declarations: 1 Aiave 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 V1(9rnTNlce of (?I@Arlfor which this permit is issued. Policy No. [ave and wit-maintein 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' ancn carrier arid'policy number are: Policy Number Date Nama ofM,gent •• ruvnc .. sariltj that, iniRe 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 agre tft..lj 49hould bpb8rA6,sub' ct to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provi/s' rfs. Signature of Applicaantnt " ,.A Date / (0.41 (J t DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby 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). Lender's Name Lender's Address By my signature below, 1 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 t"O,%�f��'nter the above -identified property for inspection purposes. �A� ci...,�h,ro ..f or....orf„ rl,e,ner nr Aidhnrlecrl Anent ///T! _ Print Prooertv Owner's or Authorized ADent's Name V/' I • H �_� �I �— Date ° L ACTION DATE BY ucus.nsrrrv.r ur a.vmruea.ru.r... FEDERAL REGULATIONS PART 61 OF 717LE40AND ..... ,.11....-1........ AQMD RULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: PERMIT EXPIRED PERMITCANCEtLED ❑ EPA ❑ AQMD ASBESTOS NOITRCAIIONIS NOT APPLICABLE TO PERMfTEXTENDED PERMIT FINAL ( 'Z PROPOSED DEMOLITION. CER77FfCATE OF OCCUPANCYISSUED - SIGNATURE: