HomeMy WebLinkAboutf2021-0013 - Permits (2)rro City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 220B 1 BAYSIDE DR N
[C
Inspector Area: 7
Owner: TABAZ CYRUS
Address: 13255 MULHOLLAND DR
BEVERLY HILLS, CA 90210
Phone;
Applicant: CASEY MONTY
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone
Code Edit : 2019
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
V-B-SPR
R3/U
0
0
Illiiiiiiiiiii II
FIRE Permit: F2021-0013
Project No : 0065-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS (X2018-0568) 84 HEADS
Legal Description: P BK 47 PG 32 PAR 2
Contractor: FIREPROOF FIRE PROTECTION
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone: 714-476-5370
Con State Lic: 876004
Lic Expire: 04/3012022
Bus Lic:
BT30040107
Lic Exp Date:
08131/2021
Worker's Compensation Insurance
Carrier:
SECURITY NATIONAL INS
Policy No:
SWC1325710
Expire:
02/1512022
2 Issued Date: 02123/2021
0 Setback- Front:
Rear:
Y Left:
Right:
Architect:
Address:
01
Phone:
State Lic:.
Engineer:
Address:
Phone:
State Lic:
Designer:
CASEY MONTY
Address:
1101 KINGSTON DR
•�
LA HABRA AC 90631
d-4
Phone:
Special Conditions: HIGH DENSITY
FEES
Construction Valuation:
$8,400.00
Building PC Fee,
$217.00
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 as :
$263.00
TOTAL FEE :
$486.00
Plan Check Fee:
$217.00 Fee Due at Permit Issuance :
$269.00
PROCESSED BY: \ OTHER DEPARTMENT:
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ZONING APPROVAL: �" 5+o mom +++ • • ISInAN C&ECKED BY::
FIRE APPROVAL: \� _ o `•' `"+� +ou • AFPROViAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISS(kA N(g 0fYX4ST VALID INSPECTION
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iWNER-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)
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
IS 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
of more than five hundred dollars ($500).
1 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,
usiness 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
nproved 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
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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
y 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, 1 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.htmi.
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 Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect.
is
icense Class License No Date 1.% h l Contractor Signatur�
IIORKERS' COMPENSATION DECLARATION
'ARNING: 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 (E100,000), IN ADDITION TO THE
DST 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:
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
erfooance of the work for which this permit is issued. Policy No.
I 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' compensatior
Isurance carrier a❑�r�o��I�cy number ana
:artier \ T f fn . \ I's11Cy.WUMber. Expiration Date
ie of Agent
certify that, in the p1
, if I should become
of
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' compensation laws of California, and
the workers' com ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions -
DECLARATION
ACTION
DATE
BY
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PERMIT FINAL
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