HomeMy WebLinkAboutF2022-0104 - Permitsw1r� City of Newport Beach -Building Division *F2022-0104*
.'�'� '.00 Civic Center Drive, Newport Beach, CA 92660
= Permit Counter Phone (949)644-3288
s:
�"��1FS1LL�i� 1 N.S. T O) R
Job Address: 2111 CRESTA DR NB
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Inspector Area: �8��. .�
Owner: SHEA HOMES LP
Address: 17848 SKY PARK CIR #D
IRVINE CA 92614
Phone: 949-346-1962
Applicant:
H C 1 SYSTEMS INC/MARK
Address:
1354 S PARKSIDE PL
ONTARIO CA 91761
Phone:
909-628-7773
Code Edit : 0
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
R2/U
0
0
FIRE permit: F2022-0104
Project No : 0546-2022
Inspection Requests Phone (949)644-3255
Description: MFR FIRE SPRINKLER MONITOR SYSTEM (X2019-3969) FOR BLDG#12
Legal Description: IRVINE SUB LOT 164 BILK 53 6.83 AC IN LOT
Contractor: H C I SYSTEMS INC Architect:
Address: 1354 S PARKSIDE PL Address:
ONTARIO CA 91761
Phone: 909-628-7773 Phone: State Lie:
Con State Lie: 905493
Lie Expire: 02/2912024
Bus Lic:
BT30042287
Lie Exp Date:
02/2812023
Worker's Compensation
Insurance
Carrier:
FEDERAL INSURANCE COMPANY
Policy No:
54309498
Expire:
03/02/2022
3 Issued Date: 03/0212022
0 Setback- Front:
X Rear:
Y Left:
Right:
Engineer:
Address:
Phone:
State Lie:
Designer:
HCI SYSTEMS INC
Address:
1354 S PARKSIDE PL
ONTARIO CA 91761
Phone:
909-628-7773
Special Conditions: 45-3A146-2A
47-1 B1484B
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OOP3C
0
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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:
ZONING APPROVAL:
FIRE APPROVAL:
'JJ
J ' 1
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -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 U 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 thA(t 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).
❑ I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signatuss."ow 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 t�&I.Nave 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://www.leginfo.ca.gov/calaw.html.
S gnlure of 9ropertp Owner or Authorized Agent Date
LICj~NSEWCOATRACTOR'S DECLARATION
Ifigrpby 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 ProfessiqK Code, a lice Sam in full force
andeffect. ,•"'
License Class .... License No Date K3�Z'ZGZ? Contractor Signature
WOE KERS',CO:ArENSATION DECLARATION
WARNII[G: FAILURERO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,000I, IN ADDITION TO THE
b39eOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
!rEQy affirm yndeivenalty of perjury one of the following declarations
I have and -All 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
Porrilance ofihe werk for which this permit is issued. Policy No.
have and AIT 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' compensa'
irance carrier and policy number are:
Policy Number
is of Agent J"e. °E_� -kTC,Yl 1
certify that, in the performance o3j�tthe work for which this
if I should become subject toA(workars' cori'Ip Imo@
of
Date
issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. '}
n�ro XZ'ZoZ L
DECLARATION REGARDING CbNSTRUCTIONN�`NQMG AGENCY
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 (Section 3097, Civil Code).
Lender's 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.
1 agree to comply with all applicable city and county ordin as and stat s relating to building construction.
I authorize representatives of this city or county to an t a ove-I atified " rop y for inspection purposes. , 7 N7
Signature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Name at L , L
AC77ON
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULA7701VSPART 51 OF T77L.E40AND
AQMD RULE 1403.
PERMITEXPIRED
❑ I SUBMITTEDASBESTOS N077FICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NORFICA77ONISNOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
b Q
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED