HomeMy WebLinkAboutF2022-0557 - PermitsCity of Newport Beach
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Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
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newportbeachca.gov/inspections
Combination Type -
Work Class - Other
F 2 0 2 2 0 5 5 7COMB Permit: F2022-0557
Plan Check No : PC2022-2712
Issued Date : 10/27/2022
Inspection Area : FIRE
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address: 20282 RIVERSIDE DR Legal Desc : N TR 2581 BLK LOT 14
Description: COMM -UNDERGROUND FIRE LINE (X2021-1530)
Owner: FRIENDS OF NEWPORT
SHELTER
Address : 20282 RIVERSIDE DR
NEWPORT BEACH, CA 92658
Phone:
Applicant: CAMERON FURRIER
Address: 1601 W ORANGEWOOD AV
ORANGE, CA 92868
Phone: (714)634-3923
Owner/Builder :
Address :
Phone
BEACH ANIMAL Contractor: A & D FIRE
Address : 7130 CONVOY CT
SAN DIEGO, CA 92111
Phone : (858) 277-3473
Con State Lic :
1069002
Lic Expire:
09/30/2024
Bus Lic:
BT30073130
Bus Lic Expire :
10/31/2022
Workers' Compensation Insurance
Carrier: AMERICAN ZURICH INS CO
Policy No: WC008315007
W. C. Expire : 1/1/2023
Architect
Address
Phone:
State Lic
Engineer:
Address
Phone:
Designer: CAMERON FURRIER
Address: 1601 W ORANGEWOOD AV
ORANGE, CA 92868
Phone: (714)634-3923
Code Edition :
2019 Fire Sprinklers : YES
Construction Valuation : $18,000.00
Type of Construction :
V-B Fire Hazard Zone : NO
Added/Now/Ti sq. ft. Bldg
Occupancy Groups :
No of Units : 0
Alteration sq. ft. Bldg :
Bldg Height:
No of Stories : 1
Added/New sq. ft. Garage: 0
TOTAL sq. ft. Bldg : 0
Building Setbacks :
Front: 20, Side: 5, Side: 5, Rear: 25
Flood Zone :
Use Zone :
X
SP-7 - Santa Ana Heights Specific Plan
1r cT 0 ,
PROCESSED BY :
SPECIAL CONDITIONS:
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 thecheckmark(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
to 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 licensors 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).
11, 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,
usiness 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
nproved for the purpose of sale).
11, 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
poly 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 I am exempt Gore 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 most have resided for at least one year prior to completion of the improvements covered by this permit, I cannot logaily
all a structure that I have built as an ownar-builder if it has not been constructed in its entirely 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:llwww,leginfo.ca,govlcalaw.html.
Tgnature of Property Owner or Authorized Agent Y,... ... Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Division 3 of the Business and Prof sslons ode, an y license I.. in full force
nd effect. License Class License No Date 0— -2-7-2z Contractor Signature
JORKERS' COMPENSATION DECLARATION
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLAR E799,DD9),I AODRION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 379E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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
ormance of the work for which this permit Is issued. Policy Nm.
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'
carrier and policy number are:
Policy Number
or Agent
Date
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
L if I should become sub D the war n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant __ Dale
CLARATION REGA ONSTR CT10N LENDIN AGENCY
areby affirm under penalty of perjury the here is a c truction lending agency for the performance of the work for which this permit is issued (Secgon 3097, Civil ode).
idei s Name Lenders 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 ordinances and,91alliqq laws relating to building construction.
I authorize representatives of this city or county tc�sqr the a. 'f it report for inspection purposes. _
nature of PrODerty Owner or Authorized ADent V Print Property Owner's or Authorized ADent's Name
ACTION
DATE I By
FOR OFFICE USE ONLY
REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
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