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Home My WebLink AboutF2021-0131 - Permits� .....4 City of Newport Beach - Building Division IIIIIIII IIIIIIIIIII IIIIIIIIIIII III I III II FIRE Permit: F2021-0131 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 1 3 1 Project No : 0760-2021 4 ir.0 Permit Counter Phone (949)644-3288 w+r S ,y c•rr ri Inspection Requests Phone (949)644-3255 Job Address: 895 DOVE ST NB St: 1 FI: 1 Unit: 100 Description: COMM FIRE SPRINKLER TI (X2021-0550) 21 HEADS Inspector Area: FIRE Legal Description: TRACT NO 7694 LOT 4 AND LOT 5 FOR OF LOT Owner: GLENBOROUGH NEWPORT PLAZA Contractor: APEX FIRE SYSTEMS INC Architect: Address: 400 S EL CAMINO REAL #1100 Address: 2961 W MACARTHOR BLVD STE 118 Address: SAN MATEO, CA 94402 SANTA ANA CA 92704 Phone: Phone: 949-337-9679 Phone: State Lic: Applicant: LOPEZ CARLOS Con State Lic: 732396 Engineer: Address: 2961 W MACARTHUR BLVD Lic Expire: 09/30/2021 Address: SANTA ANA CA 92704 Bus Lic: BT30006908 Phone: Lic Exp Date: 0113112022 Phone: State Lic: Code Edit: 2019 Worker's Compensation Insurance Designer: READ MARC Type of Construction: V-B-SPR Carrier: ACE AMERICAN INS CO Address: 2961 W MACARTHUR BLVD Occupancy Group: B Policy No: C68630538 SANTA ANA CA 92704 Added /New sq.ft. Bldg: 0 Expire: 11101/2021 Phone: Added/New sq. ft. Garage: 0 No of Stories: 2 Issued Date: 04127/2021 Special Conditions: No of Units : 0 Setback- Front: Flood Zone: Rear: Bldg Sprinklers: Y Left: Right: Construction Valuation Building PC Fee : Building Overtime PC Fee: Building Extention Fee : Building Investigation Fee Fire Plan Check Fee: Fire Permit Fee: Building Permit Fee TOTALFEE: PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: $2,500.00 FEES $0.00 Fire Residential Alarm PC Fee: $0.00 $0.00 Planning Counter Review: $0.00 $0.00 Planning Zoning PC Fee : $0.00 $0.00 $159.00 Public Works PC Fee: $0.00 $246.25 Public Works Traffic Plan Check Fee; $0.00 $0.00 $407.25 Plan Check Fee : $159.00 OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: INSPEC"T R Records Management : $2.00 $0.00 $0.00 Fee Due at Permit Issuance : $248.25 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION ER -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 rive hundred dollars ($500). ❑ 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, 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 Cade: 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 legally 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.htmi. 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 Cade, and my license is in full force and effect. V g eV /v License Class License No Da e ("Z 7— z Contractor Si natur / 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 ($100,000), 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: ❑ 1 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 P@I�ormance of the work for which this permit is issued. Policy No. L l ave 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 nsu ince carrier and policy number are: ler Policy Number Expiration 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 workers' compensation rovlsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant, CamDate,'1I DECLARATION REGARDING 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 t 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 cou ty to eatw the abo e-identifi roperty for inspection purposes. % Y"27iZ Signature of Propert Owner or Authorized Agent '"� Print Property Owner's or Authorized Agent's Name S ��i Z Date ACTION DATE BY DECLARATION OF COMPLIANCE 141TH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40AND PERA41T EXPIRED AQMDRULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: PERMITCANCELLED ❑ EPA - PERMIT EXTENDED ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO ' PERMIT FINAL p / PROPOSED DEMOLITION. CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: