HomeMy WebLinkAboutF2021-0145 - Permits��Nhr}4r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIII FIRE Permit: F2021-0145
100 Civic Center Drive, Newport Beach, CA 92660 II F 2 0 2 1 0 1 4 5 Project No: 0842-2021
H '. Permit Counter Phone (949)644-3288
`;r<ir _iµs�a Inspection Requests Phone (949)644-3255
Job Address: 895 DOVE ST NB St: 1 Ft: 1 Unit: 100
Description: COMM FIRE ALARM TI (X2021-0550) 4 DEVICES'WOODSIDE CREDIT'
Inspector Area: FIRE
Legal Description: TRACT NO 7694 LOT 4 AND LOT 5 POR OF LOT
Owner: GLENBOROUGH NEWPORT PLAZA
Contractor:
H C I SYSTEMS INC
Architect:
Address: 400 S EL CAMINO REAL #1100
Address:
1354 S PARKSIDE PL
Address:
SAN MATEO, CA 94402
ONTARIO CA 91761
Phone:
Phone:
909-628-7773
Phone:
Stale Lie:
Applicant: MYRIAM VERA
Con State Lie:
905493
Engineer:
Address: 1354 S PARKSIDE PL
Lie Expire:
0212812022
Address:
ONTARIO CA 91761
Bus Lie:
BT30042287
Phone: 909-957-5200
Lie Exp Date:
02128/2022
Phone:
State Lic:
Code Edit: 2019
Worker's Compensation Insurance
Designer:
jxq y„
Type of Construction: II-A-SPR
Carrier:
FEDERAL INSURANCE
Address:
�
Occupancy Group: B
Policy No:
54309498
Added /New sq.ft. Bldg: 0
Expire:
0910112021
Phone:
--- - -- -" 0
Added /New sq. ft. Garage: 0
No of Stories: 5
Issued Date: 04/19/2021
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
Right:r
FEES
`
Construction Valuation: $2,147.00
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee:
$0.00
Records Management:
$4.00
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:
$169.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee :
$241.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$414.00
Plan Check Fee :
$0.00 Fee
Due at Permit Issuance :
$414.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
?ERM;T EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
)WNER-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
is 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
'rofessions 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
of more than five hundred dollars ($500).
7 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
n 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
pply 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).
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
:y 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
ell 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
rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
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 Profe io s C a nd my license is in full force
nd effect.
icense Class License No Date ( I E2 Contractor Signatur.
IIORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE H TIRED THOUSAND DOLLARS 1$100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 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 IN
etformance of the work for which this permit is issued. Policy No.
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'
carder and policy number are:
is of Agent
certify that, in the performance of the
, if I should become subject to the wo
Of
Policy Number Expiration Date
Phone #
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
mpensattlor protons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
CLARATION REGARDING CONST CTION LENDING AGENCY -It
)reby affirm under penalty of perjV 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 ordinanc s and state laws relating to building construction.
I authorize representatives of this city or county to enter thg, lbove-ideoiied ploperty for inspection purposes. -
ACTION
DATE
By
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 6f OF TIILE40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMDASBESTOS
- -
"
PERMITCANCELLED
PERMIT EXTENDED
POSEDDEIMOIOIUnONISNOTAPPL/CABLETO
PROPOSED
'
PERMITFIPIAL
1D 2
CER77FICATEOF
OCCOPANCYfSSUED
SIGNATURE:
I