HomeMy WebLinkAboutF2017-0664 - Permitstrp� City of Newport Beach - Building Division II II IIIIIIIIII IIIIIIIIIIII VIII IIII III II
cr4' 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 7 0 6 6 4
h, Permit Counter Phone (949)644-3288
Job Address: 2240 UNIVERSITY DR NB
Inspector Area: FIRE
Owner: NEWPORT JEWISH CENTER INC
Address: 2240 UNIVERSITY DR #200
NEWPORT BEACH, CA 92660
Phone:
Applicant: JESSIEIPACIFIC FIRE
Address: 249 E EMERSON DR #G
ORANGE CA 92865
Phone: 714-283-021123
Code Edit : 2016
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Flood Zone: X
Bldg Sprinklers: N
FIRE Permit: F2017-0664
Project No: 2828-2017
Inspection Requests Phone (949)644-3255
Description: COMM UNDERGROUND FIRE LINE
FEES
Construction Valuation:
$15,000.00
Legal Description: P M 17642 PAR 3 FOR OF PAR
-�
Contractor: PACIFIC FIRE SUPPRESSION INC
Architect:
$0.00 Records Management:
$4.00
Address: 1010 N BATAVIA #318
Address:
Planning Counter Review:
$0.00
ORANGE CA 92867
Building Extention Fee :
$0.00
Planning Zoning PC Fee :
Phone: 714-502-0211
Phone:
State Lic:
'
$0.00
Fire Plan Check Fee:
Con State Lic: 423418
Engineer:
$0.00
='3
Lic Expire: 11130/2019
Address:,>;;..t-.,,
Public Works Traffic Plan Check Fee:
$0.00
Bus Lic: ET03042109
Building Permit Fee :
$0.00
Lic Exp Date: 03/31/2018
Phone:
State Lic:
{
Plan Check Fee :
$355.00 Fee Due at Permit Issuance :
$366.00
Worker's Compensation Insurance
Designer:
HAMILTON CHARLES
Carrier: EVEREST NATIONAL
Address:
2049 E EMESON DR
a�
Policy No: 5300001686
ORANGE CA 92065
Expire: 0911712018
Phone:
714-283-0211 EXT 22
Issued Date: 01/04/2018
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
PROCESSED BY: o m o m m •0 07HERJUEPARTMENT:
0 o m • o o••
P O CG m O f •4 m•
ZONING APPROVAL: " ` PLAN CHECKED BY::
FIRE APPROVAL: G G • .4P•PBQVAL TO ISSUE:
C O G• C C 4 O
< G G C
PERMIT EXPIRES 180.g4YI g f1—E <LSw'U$Ntt--E O/$ LUT VALID INSPECTION
FEES
Construction Valuation:
$15,000.00
Building PC Fee :
$0.00
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:
$355.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee :
$362.00
Public Works Traffic Plan Check Fee:
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$721.00
Plan Check Fee :
$355.00 Fee Due at Permit Issuance :
$366.00
PROCESSED BY: o m o m m •0 07HERJUEPARTMENT:
0 o m • o o••
P O CG m O f •4 m•
ZONING APPROVAL: " ` PLAN CHECKED BY::
FIRE APPROVAL: G G • .4P•PBQVAL TO ISSUE:
C O G• C C 4 O
< G G C
PERMIT EXPIRES 180.g4YI g f1—E <LSw'U$Ntt--E O/$ LUT 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)
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
7e 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
iot more than five hundred dollars ($500).
7 I, 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,
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
Tiproved for the purpose of sale).
7 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
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).
7 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.gov/calaw.html.
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 S ctio 70 0) of Division 3 of the Business and Prof ssi s C d ,and license is in full force
nd effect.'
.icense Class License No Date Contractor Signatu
YORKERS' 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 HUNDRUSAND 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:
I 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 IN
erforpance of the work for which this permit is issued. Policy No.
and will m in 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 A number are:
Date
of Agent
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' gompensation 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 Applicant
CLARATION REGARDING CONSTRUCTION LENDING AGENCY - I -, —
Heby 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).
Ider'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 countyc)nArances and state laws relating to building construction.
I authorize representatives of this city or county ytte a ab -identified property for inspection purposes.
nature of Prooertv Owner or Authorized Aoent !� _ __ Print Property Owner's or Authorized Agent's Na
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AC77ON DATE V BY DECLARATION OF COMPLIANCE WITH CODEOF V V FOR OFFICE USE ONLY
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