HomeMy WebLinkAboutF2022-0251 - Permitsao� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIII II FIRE Permit: F2022-0251
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 2 5 1 Project No : 1257-2022
w _ Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
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Job Address: 3049 E COAST HWY NB Description: COMM FIRE SPRINKLER TI (X2021-2790) 30 HEADS
Inspector Area: FIRE
LOTS 4/5
Legal Description: CORONA DEL MAR LOT 1 BLK 436(AND LOT 3 BILK 436(ANDTR 323
Owner: GARFIELD BEACH CVS LLC
Contractor:
RADIX FIRE PROTECTION INC
Address: 3049 E COAST HWY
Address:
1370 E WASHINGTON BLVD
CDM CA 92625
LOS ANGELES CA
Phone:
Phone:
Applicant: INHYE PARK
Con State Lic:
823302
Address: 1769 E 23RD ST
Lic Expire:
09/30)2023
LA CA 90058
Bus Lic:
BT30078714
Phone: 213-765-0384
Lic Exp Date:
05/31/2023
Code Edit: 2019
Worker's Compensation Insurance
Type of Construction: V-B-SPR
Carrier:
NORGUARD INS CO
Occupancy Group: B
Policy No:
RAWC222154
Added /New sq.ft. Bldg: 0
Expire:
06/01/2022
Added /New sq. ft. Garage: 0
No of Stories: 1
Issued Date: 05/11/2022
No of Units : 0
Setback- Front:
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
Right:
Architect:
Address:
Phone:
Engineer:
Address:
State Lic:
Phone: State Lic:
Designer: PARK INHYE
Address: 1769 E 23RD ST
LA CA 90058
Phone:
Special Conditions:
rI .IntG -�)3 ljo L)S':'
Construction Valuation:
$22,000.00
FEES
Building PC Fee:
$0.00
Fire Residential Alarm PC Fee:
$0.00
Records Management: $2.00
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:
$180.00
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$279.50
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTAL FEE :
$461.50
Plan Check Fee:
$0.00
Fee Due at Permit Issuance : $461.50
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER fPEPALRTMENT:'
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PLAN CHECKED BY::
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PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAS`Ta VALM.^ INBP+EC+Tr'ON, -..
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
ie 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
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,
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
nproved 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
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:
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 legall,
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 Section 7000) of Division 3 of the Business and Profes i_ ions Code, and my license is in full force
nd effect.
icense Class License No Date br (1 22- Contractor Signat r
PORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER,T CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE UNDRED THOUSAND DOLLARS ($100,000), 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:
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 th
erformance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
of Agent
Date
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' compensation laws of California, and
, if I should bec4rRq subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
22
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 (SFSction 3097, Civil Code).
Lenders 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 county ordinances and state laws relating to building construction.
I authorize representatives of this city or couRtylto enter the above -identified property for inspection purposes. 1 h�� P�(, I< 6rj/l(� 2
Signature of Property Owner or Authorized Agent x � X I Print Property Owner's or Authorized Agent's Name r"l Date
ACTION
DATE
DECLARATION OFCOMPLfANCE MTH CODEOF
\ FOR OFFICE USE ONLY
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