HomeMy WebLinkAboutF2022-0018 - PermitsCity of Newport Beach - Building Division *F2022-0018*
100 Civic Center Drive, Newport Beach, CA 92660
.ram^ v Permit Counter Phone (949)644-3288 _
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Job Address: 360 SAN MIGUEL DR NS
Inspector Area: FIRE
Owner: NCMB NO 4 LLC
Address: 1401 AVOCADO AVE STE 901
NEWPORT BEACH, CA 92660
Phone:
Applicant: FERRIS KELLY
Address: 8724 MILLEGROVE DR
SANTA FE SPRINGS, CA 90670
Phone: 562-325-6426
Code Edit: 2019
Type of Construction: I-B-SPR
Occupancy Group: B/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 7
No of Units : 0
Flood Zone: X
Bldg Sprinklers: Y
FIRE Permit: F2022-0018
Project No : 0095-2022
Inspection Requests Phone (949)644-3255
Description: COMM FIRE ALARM 2 DEVICES (X2020-2915)
Legal Description:
N TR 5018 LOT 31
Contractor:
ADVANCED ALARM INC
Architect:
Address:
8724 MILLERGROVE DR
Address:
SANTA FE SPRINGS CA 90670
Phone:
5621944-2356
Phone:
Con State Lic:
750871
Engineer:
Lic Expire:
06130/2024
Address:
Bus Lic:
BT30074955
Lic Exp Date:
0313112023
Phone:
Worker's Compensation
Insurance
Designer:
Carrier:
OAK RIVER INS CO
Address:
Policy No:
ADWC346149
Expire:
04/1712023
Phone:
Issued Date: 07/06/2022
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
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FERRIS KELLY
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8724 MILLEGROVE DR
SANTA FE SPRINGS, CA 90670
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FEES
Construction Valuation:
$2,500.00
Building PC Fee :
$0.00
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
$168.50
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$239.50
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$414.00
Plan Check Fee :
$414.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
7WNER-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
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 U 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).
❑ 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).
❑ 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 I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
sell a structure *0have 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 Corte, isavailable upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi.
�iq%jre of Piopegy Qwner or Authorized Agent Date
LICENSED g9NTRACTOR'S DECLARATION
I -hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) of Division 3 of the Business and Professiory od nd my license is in full force
anda`f`ect.
Ljcenge Class '". License No Date 22, Contractor Signature
Apr I
iNWERS' CbVPENSATION DECLARATION
VVK1IP'G: FAILURE TQ SEGURE 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 OPCOMPEMATIOR, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
1pp1p qbere6taffirm under penalty of perjury one of the following declarations:
Vh�✓e and.will Almain 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 th,
De gr;nance , tAd wok for which this permit is issued. Policy No.
I.gave and will rneirttain 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
insurance carrier and policy number are:
ie of Agent
certify that, in the performar
if I should become subject
Policy Number
Date
work f 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
rke ' co pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision / r;,—
lignature of Appli'an - wales -it
v
1ECLARATION REG RDIN CONSTR TI LENDING AGENCY
hereby affirm under penalty of perjury th t 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
ty 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 county ordinanc sand state laws relating to building construction. t/
I authorize representatives of this city or county to en vYna a ve-i f ified property for inspection purposes.
of
ACTION I DATE I BY
FINAL
Print ProDertv Owner's or
FEDERAL REGULATIOBSPARTti1 OF TITLE40 AND
AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NONFICATIONIS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
OCCUPANCYISSUED I I I I SIGNATURE:
FOR OFFICE USE ONLY