HomeMy WebLinkAboutF2021-0363 - PermitsCity of Newport Beach - Building Division "F2021-0363* FIRE Permit: F2021-0363
100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1907-2021
12 Permit Counter Phone (949)644-3288
ND :
Y'atrroAK * Inspection Requests Phone (949)644-3255
Job Address: 1228 MARIAN LN NS
Description: SFR FIRE SPRINKLER SYSTEM 81 HEADS (X2021-0116)
Inspector Area: 3
Legal Description:
N TR 1973 LOT 18
Owner: RENEGADE REAL ESTATE SOLUTIONS LLC Contractor:
GGP INC
Architect:
^
Address: 1228 MARIAN LN
Address:
4765 GATESHEAD RD
Address:
-
NEWPORT BEACH, CA 92660
CARLSBAD CA 92010
Phone:
Phone:
760-729-2675
Phone:
State Lic: "
Applicant: GOMEZ GENRY
Con State Lic:
711174
Engineer:
Address: 4785 GATESHEAD RD
Lic Expire:
08/31/2021
Address:
CARLSBAD, CA 92010
Bus Lic:
BT03031904
Phone: 760-729-2675
Lic Exp Date:
02/28/2022
Phone:
State Lic: '
Code Edit: 2019
Worker's Compensation
Insurance
Designer:
GOMEZ GENRY
Type of Construction: V-B-SPR
Carrier:
STATE FUND
Address:
4785 GATESHEAD RD
Occupancy Group: R3/U
Policy No:
9043197
CARLSBAD, CA 92010
Added /New sq.ft. Bldg: 0
Expire:
02/01/2022
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Issued Date: 0811912021
Special Conditions:
CHANGE OF CONTRACTOR
No of Units : 0
Setback- Front:
FROM F2021-0294
Flood Zone:
Rear:
Bldg Sprinklers: N
Left:
_
Right:
FEES
Construction Valuation:
$3,500.00
Building PC Fee :
$222.00
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:
$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 :
$493.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$493.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
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 thg 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 Iicensure 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).
1, 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 Pmfassions 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
1,
improved for the purpose of sale).
I, as owr,er 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).
am exempt from Iicensure under the Contractors' State License Law for the following reason:
By my signatlre ts:cw 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
sill 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 Coda is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html.
Signature of PrDpcGy Owner or Authorized Agent Date
LENSED CCNTRACTOR'S DECLARATION
:LErdby affirm ,-nde- penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profession ode, an my license is in full force
and ef: ct. / \ / �l—
��I inersn. Class License No Date I �Z/ Contractor Signature
�W^RKERS' :,i,MPENSATION 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 ($100,000), 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:
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 the
performance of the work for which this permit is issued. Policy No.
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' compensatior
rance carrier and policy number are:
Policy Number
Date
Name of Agent Phone #
I 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
that, if I should become/subject to the wo rs' coommp/ ation�provisions
soof Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of ApplicantY `" Date
NNG CONV
DECLARATION REG9R R - ION 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 ( action 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 ordman and aws relating to building construction.
I authorize representatives of this city or co n to en e-idprilfiecl property for inspection purposes. c}
ized 7
Signature of Property Owner or AuthorAgen Print Property Owner's or Authorized Agent's Name 'D 1 let
�l —G 1
ACTION
HATE
BY
DECLARATION OF COMPLIANCE MTN CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ / SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIRCATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIRCATEOF
SIGNATURE:
OCCUPANCYISSUED
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