HomeMy WebLinkAboutF2020-0283 - PermitsCity of Newport Beach -Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
l , 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 0 0 2 8 3
•} Permit Counter Phone (949)644-3288
Job Address: 1025 W BALBOA BLVD NB
FIRE Permit: F2020-0283
Project No : 1176-2020
Inspection Requests Phone (949)644-3255
Description: NEW SFR FIRE SPRINKLERS (45 HEADS) X2020-1096
Inspector Area: 1 Legal Description: TR 234 LOTS 17&18 BLK 10
Owner: KEILCH ROBERT
Contractor:
ACER FIRE PROTECTION, INC
Architect:
Address: 227 20TH ST STE0100
Address:
4661 MANE ST
Address:
NEWPORT BEACH, CA 92663
MONTCLAIR, CA 91763
Phone:
Phone:
626-606-8888
Phone:
Applicant: ACER FIRE PROTECTION, INC
Con State Lie:
1047478
Engineer:
Address: 4661 MANE ST
Lie Expire:
12131/2020
Address:
MONTCLAIR, CA 91763
Bus Lie:
BT30063345
Phone: 626-606-8888
Lie Exp Date:
07/31/2021
Phone:
Code Edit: 2011
Worker's Compensation Insurance
Designer:
Type of Construction: V-B-SPR
Carrier:
OHIO SECURITY INSURANCE
Address:
Occupancy Group: R31U
Policy No:
XWS60720416
Added /New sq.ft. Bldg: 0
Expire:
112/12/2020
Phone:
Added /New sq. ft..Garage: 0
No of Stories: 3
Issued Date: 07/0812020
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: Y
Left:
Right:
INSPECTOR
State Lie:
State Lie
BACA HECTOR
4661 MANE ST
MONTCLAIR CA 91763
626.606-8888
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FEES
°•.°
Construction Valuation:
$4,500.00
m
Boa•°
o °
° °
Building PC Fee:
$202.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
°. •$2.00
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
°OEd"'
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:
$240.00
TOTAL FEE :
$444.00
Plan Check Fee :
$202.00 Fee Due at Permit Issuance:
$242.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY:: ,t
APPROVAL TO ISSUE:
PERMIT EXPIRES 100 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason (a) indicated below by the checkmark(s) I have placed next to the applicable item(s)
ction 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
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
fessions 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
more than five hundred dollars ($500).
I, 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,
iness 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
rovements 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
roved 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
ly 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).
U I 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 coven
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
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 B iness and P" o e ion ode, and my license is in full force
and effect.
License Class License No D ' Contractor E nature
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 HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 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
performance of the work for which this permit is issued. Policy No.
:his permit, I cannot
of the Business and
and will•maiMilain 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 aw6policy number are:
Policy Number
ie of Agent • • rnm
csraiiy that, in A performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become
if Lshould bpt6fi bj o e workers' c pen/sa�tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with the
Iatft of ADpli. t =" z of
of perjury that there is a construction lending agency for the performance of the work for which this permit is
Lender's Address
By my sitnature balo ,, f certify to each of the following:
• I pV the property owner or authorized to act on the property owner's behalf.
• • I r1va read Ihds•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 o,Kc my to W%;hS%bWjde9JJW property for inspection purposes.
Date
to the workers' compensation laws of California, and
�10
3097, Civil Code).
ACTION
DA It
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TI TLE40AND
AQMDRULE 1403.
PERMIT EXPIRED
0 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
0 AQMD
PERMITCANCELLED
PERMITEXTENDED
0 ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
(3
CERTIF1CAT€OF
SIGNATURE:
OCCUPANCYISSUED