HomeMy WebLinkAboutF2021-0272 - Permitsvr,;� City of Newport Beach - Building Divisiorie' I�II��I�III�IIII II I �II�,�I�IIII II FIRE Permit: F2021-0272
I r „� 100 Civic Center Drive, Newport Beach, CA 92660 • .�F°0 t' e z Project No :1487-2021
4. ( ;(, yr Permit Counter Phone(949)644-3288 •'O • , e,•®, ®.•
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�acrmma'�> 1 `I1 (/ ,/��// (\� ,�/^, .^�/'/�!/ r\wry ° e Inspection Requests Phone (949)644-3255
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Job Address: 610 NEWPORT CENTER DR NB St: 1 FI: 3 Unit: 370 Description: COMM FIRE SPRINKLERS (4) HEADS (X2021-1382)
Inspector Area: FIRE
Owner: 610 NEWPORT CENTER DR LLC
Address: PO BOX 2450
NEWPORT BEACH, CA 92658
Phone:
Applicant:
ANDERSON ROBERT
Address:
2810 E MIRALOMA DR
Occupancy Group:
ANAHEIM CA 92806
Phone:
714-635-6500
Code Edit: 2019
P BK 295 PG 33 PAR 4
Type of Construction:
I -A -SPR
Occupancy Group:
B
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
18
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
Legal Description:
P BK 295 PG 33 PAR 4
Contractor:
FIRE PROT SPECIALISTS
Address:
2810 E MIRALOMA AVE
Building PC Fee:
ANAHEIM CA 92806
Phone:
714-635-6500
Con State Lic:
464915
Lic Expire:
1013112022
Bus Lic:
BT30042894
Lic Exp Date:
05131/2022
Worker's Compensation
Insurance
Carrier:
COMP WEST INS. CO.
Policy No:
WCV5502952
Expire:
12/02/2021
Issued Date: 07/01/2021
Setback- Front:
Rear:
Left:
Right:
IITOTAL FEE : $325.00 Plan Check Fee
PROCESSED BY: V °�
ZONING APPROVAL:
FIRE APPROVAL:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
State Lic:
State Lic:
Designer:
ANDERSON ROBERT
FEES
Construction Valuation:
$1,200.00
ANAHEIM CA 92806
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:
$128.00
Public Works PC Fee
Fire Permit Fee :
$195.00
Public Works Traffic Plan Check Fee;
Building Permit Fee :
$0.00
IITOTAL FEE : $325.00 Plan Check Fee
PROCESSED BY: V °�
ZONING APPROVAL:
FIRE APPROVAL:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
State Lic:
State Lic:
Designer:
ANDERSON ROBERT
Address:
2810 E MIRLOMA AVE
ANAHEIM CA 92806
Phone:
714.635.6500
Special Conditions:
$0.00 Records Management
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance :
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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0
L.�'�J
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$2.00
$0.00
$0.00
$325.00
)WNER-BUILDER DECLARATION •�: ��% • • ,' .•
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale l`censo Law forth% re'Dspn(s) ndicated 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 per%t6to"iJstru6t, a6r, imptove102molish, 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: Nil
.do L}all df or jJpoNons' of file avork, 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 4n owll6tr of property who, throup grjloyees' or personal effort, builds or improves the property, provided that the
nprovements are not intended or offered for sale. If, however, the building or improvem"t iSShcd wifhln 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 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:http://www.leginfo.ca.govlcalaw.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Res ' ns Code m license is in full force
nd effect.
icense Class License No Date °l Z Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
L ave 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 tht
er rmance of the work for which this permit is issued. Policy No.
and will mainta(fTFwQrkers' compen�t'lpn insurance, as requ(r�c1� y Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
carrier and poli nu ber are: ` j ) ,r
is of Agent r
certify that, in the performymance of the work
I , if I should suj5ject to,117�vorkers'
Iatu re of Applicant
Date
is hued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
ions of Section 3700 of the Labor Code, I shall forthwith comply with those prrions/
hereby affirm under 0nalty 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).
Ender's Name Lender's Address
Iy 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 pry) ided is correct
.
agree to comply with all applicable city and county orgi)falJlce and stat laws r la'�g to building construction.
authorize representatives of this city or co ty en) eove ified p p for inspection purposes.
ionature of Property Owner or Authorized Agent (�yjj��r int Property Owner's or Authorized Agent's NamV'�3 k9t
ACTION
DATE BY
DECLARATION OF COMPLIANCE tMTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40AND
AQMD RULE 9403.
-
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD'
PERMIT CANCELLED
PERMIT: EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
1(L
CERTIFICATEOF
SIGNATURE:.
OCCUPANCYISSUED