HomeMy WebLinkAboutf2021-0458 - Permitswl= City of Newport Beach - Building Division FIRE Permit: F2021-0458
�.: 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 2302-2021
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949j6 4-3255
Job Address: 508 ACACIA AVE NB
Description: MFR FIRE SPRINKLERS (X2020-1641) 41 HEADS
Inspector Area: 5
Legal Description: CORONA DEL MAR BILK 529 LOT 10
Owner: AFSHAR SETAREH
Contractor:
FIREPROOF FIRE PROTECTION
Architect:
Address: 508 ACACIA AVE
Address:
1101 KINGSTON DR
Address:
,
CORONA DEL MAR, CA 92625
LA HABRA CA 90631
Phone:
Phone:
714-476-5370
Phone:
State Lie:
Applicant: CASEY MONTY
Con State Lie:
876004
Engineer:
0°°°,
°
Address: 1101 KINGSTON DR
Lie Expire:
04130/2022
Address:
• ° • °
LA HABRA CA 90631
Bus Lie:
BT30040107
Phone:
Lie Exp Date:
0713112022.
Phone:
State Lie:
0,0 o �'
Code Edit : 2019
Worker's Compensation
Insurance
Designer:
CASEY MONTY
'
Type of Construction: V-BSPR
Carrier:
SECURITY NATIONAL INS
Address:
1101 KINGSTON DR
• ° • o
Occupancy Group: R3/U
Policy No:
SWC1325710
LA HABRA CA 90631
Added /New sq.ft. Bldg: 0
Expire:
02/15/2022
Phone:
714-476-5370
....
Added/New sq. ft. Garage: 0
°oo�•°
No of Stories: 2
Issued Date: 09/30/2021
Special Conditions:
No of Units : 0
Setback- Front:
o °
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
Right:
0o
•
FEES
Construction Valuation: $4,100.00
Building PC Fee:
$222.00
Fire Residential Alarm PC Fee :
$0.00
Records Management:
$6.00
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:
$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 :
$269.00
1ITOTAL FEE : $4,-q.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $497.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
r IFS APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPEC ON
g�
Y 4^
• •
IINER-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)
rction 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
rfessions 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 U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
ainess 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
fly 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
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 Iegalll
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
Ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
nature of Propecty.Owner or Authorized Agent Date
TENSED CbNT.RACTOR'S DECLARATION
Ke4yy:affirm uw1pr enalty 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
t effePct. • • •
;ns2•Class License No Date + Zk Contractor Signature v'
AKERS' COMPENSATION DECLARATION
ININ(j: FAILU'oo��1ccrr TO SEMRE 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
3i%F COMPENSTITICIS, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
i45EFolicy
RB@rnalty of perjury one of the following declarations:
will maintain a certificate of consent toself-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
the work for which this permit is issued. Policy No.
}I�fia�ltain 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' compensatiol
and eolicy number are: • • • • Policy Number Expiration Date
to of Agent _
certify that, in the pi
, if I should become
lature of Applicant -
)Ee of the work forwhich 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
to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi/slgflS.
/
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, 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 c unty ordinances and state laws relating to building construction.
I authorize representatives of this city or c my to enter the above -identified property for inspection purposes.
Signature of Property Owner or Authorized gent't Print Property Owner's or Authorized Agent's Name M•.. �- �e rs ate u 3 • it
ACTION
ATE
BY
DECLARATION OF COMPLIANCE kWTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OF TITLE WAND
AQMD RULE 1403.
PERMIT EXPI RED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:.
❑ EPA
❑ AQMD'
PERMtTCANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
C€R77FICAT€OF
SIGNATURE:
OCCUPANCYISSUED