HomeMy WebLinkAboutF2021-0037 - Permits (2)wr' City of Newport Beach - Building Division IIIGIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 2 0 2 1 8 8 3 7
y- Permit Counter Phone (949)644-3288
FIRE Permit: F2021-0037
Project No : 0186-2021
Inspection Requests Phone (949)644-3255
Job Address: 710 JASMINE AVE NB
Description: SFR - FIRE SPRINKLERS/ADD 24 HEADS (X2020-0586)
0186-2021
Inspector Area: 6
Legal Description:
CORONA DEL MAR BLK 737 LOT 12
Owner: PIGAZZI ALESSIO
Contractor.
ACT FIRST FIRE PROTECTION INC
Architect:
Address: 710 JASMINE AVE
Address:
1325 N RED GUM STREET #10
Address:
CORONA DEL MAR, CA 92625
ANAHEIM CA 92806
Phone:
Phone:
714-630-3916
Phone:
State Lie:
Applicant: KENTON NAEVE
Con State Lie:
830883
Engineer:
Address: 1325 N RED GUM
Lie Expire:
03131/2022
Address:
ANAHEIM CA 92605
Bus Lic:
BT30030288
Phone: 714-630-3916
Lie Exp Date:
11130/2021
Phone:
State Lie:
Code Edit : 2019
Worker's Compensation
Insurance
Designer:
NAEVE KENTON
Type of Construction: VB
Carrier:
SECURITY NATIONAL
Address:
1325 N RED GUM
Occupancy Group: R3/U
Policy No:
SWC1188764
ANAHEIM CA 92605
Added /New sq.ft. Bldg: 0
Expire:
03112/2021
Phone:
714-630-3916
Added /New sq. ft. Garage: 0
No of Stories: 2
Issued
Date: 0212212021
Special Conditions:
HIGH DENSITY AREA
No of Units : 0
Setback- Front:
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
Right:
FEES
Construction Valuation: $3,000.00
Building PC Fee :
$217.00
-
Fire Residential Alarm PC Fee :
$0.00
Records Management:
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
Fire Plan Check Fee:
$0.00
Public Works PC Fee :
$0.00
Fire Permit Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$263.00
TOTAL FEE :
$4y8�4000
Plan Check Fee:
$217.00
Fee Due at Permit Issuance
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PERMIT EXPIRES 180 DAYS AFTIN IS$IiAN QL° Cp LAST VAbd INSPECTION
$4.00
$0.00
$0.00
$267.00
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item (a)
(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 (_) 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 1 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.govicalaw.html.
Signature of Property Owner or Authorized Agent Da
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 Professi s de, my license is in full force
and effect. �i
Z 2 Contractor Signat�l
License Class License No Date
WORKERS' COMPENSATION DECLARATION
NARNING: 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 THI
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
131 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 tl
oesf6rmance of the work for which this permit is issued. Policy No.
have 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'
rance carrIk�,Vd policy number�are: I A
Number
Date
re of Agent ➢-"""� "
certify that, in the performance th wok 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 yubject to a rke�s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant- Uare �-
IECLARATION RE R NG CO STR TION LENDING AGENCY
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).
ender's Name Lender's Address
y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property own is behalf.
1 have read this application and the information I have prov d i corr ct.
1 agree to comply with all applicable city and county ordin nc s nd st to laws relating to building construction.
I authorize representatives of this city or county t9'enter t ab a-iden 'tied property for inspection purposes. 1�
;.....,r.— ,.r D.,...va„ n,.,,.o� — A. aH�a�ed A„onr7/ -Print Prooertv Owner's or Authorized AGent's Named A 4nm)
ACTION DATE RY I— --- —
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