HomeMy WebLinkAboutF2021-0392 - Permits�wr• City of Newport Beach - Building Division ����������������������������������������������������������� FIRE Permit: F2021-0392
C r 100 Civic Center Drive, Newport Beach, CA 92660 Project NO : 207$-2021
?.' Permit Count0er Phone (949)644-3288
r''zr.,uv�ta Inspection Requests Phone (949)644-3255
Job Address: 424 FERNLEAF AVE NB
Description: FIRE SPRINKLERS/NEW DUPLEX (42) HEADS X2021-0208
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Inspector Area: 5
Legal
Description:
CORONA DEL MAR BLK 433 LOT 6
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Owner: BIRE II LLC
Contractor:
FIREPROOF FIRE PROTECTION
Architect:
Address: 7642 W IRVING PARK RD
Address:
1101 KINGSTON DR
Address:
6�
NORRIDGE IL 60706
LA HABRA CA 90631
Phone:
Phone:
714-476-5370
Phone: State Lic:41
d-
Applicant: FIREPROOF FIRE PROTECTION
Con State Lic:
876004
Engineer:
Address: 1101 KINGSTON DR
Lic Expire:
04/30/2022
Address:
LA HABRA CA 90631
Bus Lic:
BT30040107
Phone: 714-476-5370
Lic Exp Date:
07/31/2022
Phone: State Lic:
Code Edit : 2019
Worker's Compensation Insurance
Designer: CASEY MONTY
Type of Construction: V-B-SPR
Carrier:
SECURITY NATIONAL INS
Address: 1101 KINGSTON DR
Occupancy Group: R3/U
Policy No:
SWC1325710
LA HABRA CA 90631
Added /New sq.ft. Bldg: 0
Expire:
02/1512022
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 3
Issued
Date: 0910912021
Special Conditions:
No of Units: 0
Setback -Front:
°°°•
Flood Zone:
Rear:
Bldg Sprinklers: Y
Left:
°°a°°•
, ,
Right:
FEES
-°°°°
Construction Valuation: $4,200.00
a °pB•
°O°°
0000
°
Building PC Fee :
$222.00
Fire Residential Alarm PC Fee,
$0.00 Records Management :
08.00
....
Building Overtime PC Fee:
$0.00
Planning Counter Review:
$0.00
° • °
° • e
Building Extention Fee :
$0.00
Planning Zoning PC Fee:
$0.00
Building Investigation Fee:
$0.00
0 $q�p0
Fire Plan Check Fee:
$0.00
Public Works PC Fee :
$0.00
®• •$il°in
Fire Permit Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
°
Building Permit Fee :
$269.00
TOTAL FEE :
$499.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$499.00
PROCESSED BY:
OTHER DEPARTMENT:
ZONING APPROVAL:
PLAN CHECKED
BY::
FIRE APPROVAL:
/ (c„
APPROVAL TO ISSUE: i
PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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).
111, 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).
❑ I 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 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo,ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I 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
and effect.
License Class License No Date � f1 , Contractor Signature � •'! "L
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 have and•Mifl 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 the
p rforniance of rile"rk forwhich this permit is issued. Policy No.
i JI aie and Will•rpaiDtain 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
ante came? &M&policy number are:
Policy Number
Date
ams of Ager4 •" Phone #
jI•certify that, in theperformance 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
12'4f•I should �ieoorpe subj 't to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
.9ca CX � et
j�natur�e^of I.. y I A Date
• •w i _ nwr_ nnraeToi i ouniur_ nr_vury
.ety affirr11u nderpenalty 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).
SAi''s Name Lender's Address
my signatmw6,b c;v, 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 county to eLr the above --identified property for inspection purposes.
lature of Property Owner or Authorized Agent / Print Property Owner's or Authorized Agent's Name
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 51 OF TITLE40AND
AQMDRULE 1403,
PERMITEXPiRED
❑ 1 SUBMITTEDASBESTOS NO77FICATION TO:
❑ EPA
❑ AQMD
PERMfTCANCELED
PERMIT EXTENDED
❑ ASBESTOSNOTIFICATION/S NOTAPPIXABt.ETO
PROPOSED DEMOLITION.
PERMIT F1NAt
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—
CER77FICATEOF
SIGNATURE:.
OCCUPANCYISSUED