HomeMy WebLinkAboutF2022-0103 - Permitss'rr� City of Newport Beach - Building Division *F2022-0103*
a' 100 Civic Center Drive, Newport Beach, CA 92660
n Permit Counter Phone (949)644-3288
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FIRE Permit: F2022-0103
Project No : 0545-2022
Inspection Requests Phone (949)644-3255
Job Address: 2101 CRESTA DR NB
Description: MFR FIRE SPRINKLER MONITOR SYSTEM (X2019-3970) FOR BLDG#13
Inspector Area: / (//(
Legal Description:
IRVINE SUB LOT 164 ELK 53 5.83 AC
IN LOT
Owner: SHEA HOMES LP
Contractor:
H C I SYSTEMS INC
Architect:
Address: 17848 SKY PARK CIR #D
Address:
1354 S PARKSIDE PL
Address:
IRVINE CA 92614
ONTARIO CA 91761
Phone: 949-346-1962
Phone:
909-628-7773
Phone: State Lie:
Applicant: H C I SYSTEMS INC/ MARK
Con State Lie:
905493
Engineer:
Address: 1354 -S PARKSIDE PL
Lie Expire:
02/29/2024
Address:
ONTARIO CA 91761
Bus Lie:
BT30042287
Phone: 909-628-7773
Lie Exp Date:
02128/2023
Phone: State Lic:
Code Edit: 0
Worker's Compensation
Insurance
Designer: H C I SYSTEMS INC
Type of Construction: V-B-SPR
Carrier:
FEDERAL INSURANCE COMPANY
Address: 1354 S PARKSIDE PL
Occupancy Group: R2/U
Policy No:
54309498
ONTARIO CA 91761
Added /New sq.ft. Bldg: 0
Expire:
03/0212022
Phone: 909-628-7773
Added /New sq. ft. Garage: 0
No of Stories: 3
Issued Date: 03102/2022
Special Conditions: 49-3A/50.2A
No of Units : 4
Setback- Front:
51-1 C/52-4C
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
,
Right:
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FEES
Construction Valuation:
$5,000.00
Building PC Fee :
$222.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
$12.00
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
TOTAL FEE :
$503.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$503.00
PROCESSED BY: 13-7
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 130 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
I
INER-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)
fiction 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
fessions 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).
1, 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 signatul449low 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 legal
a structure UiotPhave 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://w .leginfo.ca.gov/calaw.htm].
RE:ure of property Owner or Authorized Agent Date
affirm ufider 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 ens full force
....
Class ....� License No Date �C 3-Z-L0.7.Z Contractor Signature �71::��
ERS'.E0r9PENSATION DECLARATION
: FAILURE4O SECURE 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
COMPENS@TION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
affirm yndejgenalty of perjury one of the following declarations:
ve anl"Ii 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 IN
ance of3he Work forwhich this permit is issued. Policy No.
e and -wit? mafitain 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
:e carrier and policy number are:
Policy Number
fie of Agent ?.ems ��cvr {—
certify that, in the performance o;tte work for which
. if I should become sUblect to tfie horkeis' conTnns
of
Date
is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
%X1 ?.2-/CYZ-Z.
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
!reby 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).
Ider's Name Lender's Address
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 ordin es and tale laws relating to building construction.
I authorize representatives of this city or county t ant h abe-ide tified operty for inspection purposes. �M J �C^ „�`1 /✓�
nature of Property Owner or Authorized Agent 1 / Print Property Owner's or Authorized Agent's Name s'LUC C�rv,/� 1J py
ACTION
DATE
BY
DECLARATION OF COMPLIANCE VWTH CODE OF
FOR OFFICE USE ONtY
FEDERAL REGULATIONSPART 51 OFTITLE40AND
AQMO RULE 1403.
PERMITEXPIRED
❑ ISUBMfTTEDASBESTOSNOTIFICATIONTO:.
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIRCATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
O a
CERTIFICATEOF
SIGNATURE:.
OCCUPANCYtSSUED