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Home My WebLink AboutF2021-0456 - Permits"''`"� City of Newport Beach - Building Division 111p111111111p11111p11111111111p11111p111111111 JillFIRE Permit: F2021-0456 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 4 5 6 Project No : 2283-2021 u ; 'qr Permit Counter Phone (949)644-3288 0',3 raq�%mac- Inspection Requests Phone (949)644-3255 Job Address: 216 SAPPHIRE AVE NB Description: SFR FIRE SPRINKLERS (27) HEADS (X2021-0135) Inspector Area: 2 Legal Description: BALBOA ISLAND SEC 2 BLK 8 LOT 10 Owner: PERRY DANIEL/NILOUFAR Contractor: FIREPROOF FIRE PROTECTION Architect: Address: 26073 SHADOW ROCK LN Address: 1101 KINGSTON DR Address: VALENCIA CA 91381 LA HABRA CA 90631 Phone: - Phone: 714-476-5370 Phone: State Lie: Applicant: MONTY CHASE Con State Lie: 876004 Engineer: Address: 1101 KINGSTON DR Lie Expire: 0413012022 Address: LA HABRA CA 90631 Bus Lic: BT30040107 Phone: 714-476-5370 Lie Exp Date: 07/31/2022 Phone: State Lie: 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: 714-476-5370 Added /New sq. ft. Garage: 0 No of Stories: 3 Issued Date: Special Conditions: No of Units : 0 Setback- Front: Flood Zone: X Rear: Bldg Sprinklers: Y Left: Right: FEES Construction Valuation: $2,700.00 Building PC Fee, $222.00 Fire Residential Alarm PC Fee : $0.00 Records Management: 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 Fire Plan Check Fee: $0.00 Public Works PC Fee: $0.00 Fire Permit Fee: $0.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee: $269.00 TOTAL FEE : $y� Plan Check Fee : $0.00 Fee Due at Permit Issuance ZONING APPROVAL: FIRE APPROVAL: ° .e o°OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: oac a a °ea °a PERMIT EXP%RE$ 180 OA YS-,AF EET ISSUA VCE OR LAST VALID INSPECTION B6e flv eti o e sae Ri $6.00 $0.00 $0.00 $497.00 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 L) 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 legal) 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://www.leginfo.ca.gov/calaw.html. 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 Z.- 11 Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 pe - rmance of the work for which this permit is issued. Policy No. I have 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' compensatio insurance carrier gticy number arrier fit. �Iicy r Expiration Date Name of Agent • i �Phone # _ -11 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 agre hat, if I should become s (act to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those eroyc vislyyyns. Signature of Applican : , , ` / D T` �1� �11, L DECLARATION RE(fAR NG CONSTRUCTION LENDING 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. 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 t enter the above -identified property for inspection purposes. Signature of Property Owner or Authorized AgentPrint Property Owner's or Authorized Agent's Name • �- Li'l D 1 tt AC77ON DATE 73Y DECLARATION OF COMPUANCEV✓lFN CODE OF .. FOR OFFICE USE ONLY FEDERAL REyVL'1I'f$7NS Pe/4RF 6?QF FPFj`c$0/1Nj} A4hfDRlILE 03. • .� • •, ❑/SUSM(iJ€D:4$8tS7bS.NVi.7(SiESYTd7N%Tii ❑ EPA • • PERMrrExp€R,=D PERMIT CANCELLED ❑ AQMD.. PERMIT EXTENDED ❑ ASBESTOS NDIIRCAADN(SNOT APPLICABLE FD PRDPDSED(jL'4DfJf4)IJe�• eye ••• ':� • . e • • e e a e • tl 'o PERMIT FINAL CER71F fCA7E OF OCCUPANCYf55UED SIGNATURE: ' o 0 0 tl o 00 000 tl C OCtl 00 OOP