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HomeMy WebLinkAboutF2021-0204 - Permits(9) City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII FIRE Permit: F2021-0204 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 2 0 4 Project No : 1156-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 502 VIA LIDO NORD NB Description: SFR FIRE SPRINKLER SYSTEM (37) HEADS (X2020-2749) *REVISED 02/01/2022 Inspector Area: 2 Legal Description: TR 907 LOT 493 ALL -EX NWLY 40 FT - Owner: HOFFMAN CHRISTINE S Contractor: FIREPROOF FIRE PROTECTION Architect: r Address: 502 VIA LIDO NORD Address: 1101 KINGSTON DR Address: NEWPORT BEACH, CA 92663 LA HABRA CA 90631 Phone: Phone: 714-476-5370 Phone: State Lic: 01 Applicant: FIREPROOF FIRE PROTECTION Con State Lic: 876004 Engineer: Address: 1101 KINGSTON DR Lic Expire: 0413012022 Address: LA HABRA CA 90631 Bus Lic: BT30040107 Phone: 714-476-5370 Lic Exp Date: 07/31/2022 Phone: State Lic: 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: 02/15/2022 Phone: 714-476-5370 Added /New sq. ft. Garage: 0 No of Stories: 2 Issued Date: 05/24/2021 Special Conditions: No of Units : 0 Setback- Front: Flood Zone: Rear: Bldg Sprinklers: N Left: Right: FEES Construction Valuation: $3,300.00 Building PC Fee : $217.00 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: $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 : $263.00 TOTAL FEE : $484.00 Plan Check Fee : $484.00 Fee Due at Permit Issuance : $0.00 PROCESSED BY: _ CTn ER D[;.PAR.,WENT: ZONING APPROVAL: P'-1N CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: \ PERMIT EXPIRES 180 DAYS AFTZFR ISSUANCE bR '.AST VALID INSPECTION IWNER-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 ie 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 Secti n 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of a 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 ployees' 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 camp) tion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). J I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor 1 am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one y ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I un 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginl signature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of nd effect. icense Class License No Dat;>Cl 1 t 11 k COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL' 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: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of erf9irmance of the work for which this permit is issued. Policy No. have and wi Intain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the rance carrier altdbolicv number,ax-a� _ r` r1. ,. is of Agent `6--all— /Jl'� certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwit nature of Applicant O!NCLARATION REGARD G CONSTRUCTION LENDING AGENCY areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county toXnfer the above -identified property for inspection purposes and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). to completion of the improvements covered by this permit, I cannot that a copy of the applicable law, Section 7044 of the Business and 'calaw.html. Date 3 of the Business and Professions Code, and my license is in full force Contractor Signatue)c ,Z� CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date as to become subject to the workers' compensation laws of California, and imoly with those,orovis ions. permit is issued (Section 3097, Civil Code). �ISignature of Property Owner or Authorized Agent �`. Print Property Owners or Authorized Agent's Name/L P''\ •d . L.a Date" \ "lt v f 4 11 ACTION DATE BY DECLARATION OF COMPLIANCE WlT' CODE OF FOR OFFICE USE ONLY .. FEDEPAL REGULATIONS PART61 OF i:QMD RULE 14113. - TITLE40AND' PERMITEXPIRED ❑ 1 SLIBMI FTED ASFk-STOS VORR ❑' EPA ATIONTO: PERMIT CANCELLED - ❑ AOMD PERP:AT EXTENDED ❑ ASBESTOS NOTIFICATION IS N04 OROPOSED DEMOLITION. APPLICABLE TO PERMIT FINAL _ CERP 4CATE CF S:CNATI RE: OCCUPANCYISSVED �lwhl,4, City of Newport Beach - Building Division "F2021-0204` FIRE Permit: F2021-0204 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 1156-2021 i v Permit Counter Phone (949)644-3288 q Y Inspection Requests Phone (949)644-3255 Job Address: 502 VIA LIDO NORD NB Description: SFR FIRE SPRINKLER SYSTEM 33 HEADS (X2020-2749) Inspector Area: 2 Legal Description: TR 907 LOT 493 ALL -EX NWLY 40 FT- LU Owner: HOFFMAN CHRISTINE S Contractor: FIREPROOF FIRE PROTECTION Architect: Address: 502 VIA LIDO NORD Address: 1101 KINGSTON DR Address: "© NEWPORT BEACH, CA 92663 LA HABRA CA 90631 ,' _ Phone: Phone: 714-476.5370 Phone: State Lic: , o' �'� ' Applicant: FIREPROOF FIRE PROTECTION Con State Lic: 876004 Engineer: �' Address: 1101 KINGSTON DR Lic Expire: 04/30/2022 Address: I— Q' ' LA HABRA CA 90631 Bus Lic: BT30040107 Phone: 714-476-5370 Lic Exp Date: 08/31/2021 Phone: State Lic: ' 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: R3/1-1 Policy No: SWC1325710 LA HABRA, CA 90631 Added/New sq.ft. Bldg: 0 Expire: 02/15/2022 Phone: 714-476.5370 Added /New sq. ft. Garage: 0 No of Stories: 2 Issued Date: 05/24/2021 Special Conditions: O " O No of Units : 0 Setback- Front: Flood Zone: Rear: O Bldg Sprinklers: N Left: Right: z FEES Construction Valuation: $3,300.00 Building PC Fee : $217.00 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 $0.00 Building Investigation Fee: Fire Plan Check Fee: $0.00 $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 : $263.00 TOTAL FEE : $484,00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $484.00 DEPARTMENT: PROCESSED BY: OTHER ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION ILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) in icated below by the checkmark(s) I have placed next to the applicable items) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, de olish, 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 Vaw (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 Sec ion 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 U 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 com letion, 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 Droperty who builds or improves thereon, and who contracts for the projects with a licensed Contract pursuant to the Contractors' State License Law). I am exempt from icensure under the Contractors' State License Law for the following reason: )EFy mv.;ignature below I acknowledge that, except for my personal residence in which I must have resided for at least one ear prior to completion of the improvements covered by this permit, I cannot legall, 'sell a structure the t I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I u derstand 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.legi fo.ca.gov/calaw.html. 'Signature of Proparty Owner or Authorized Agent I Date (LICENSED CONTRACTOR'S DECLARATION nl ilhereby affirm Lrder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Division 3 of the Business and Professions Code, and my license is in full force and effect. I11_ic6ris= Class __ _ _ License No Date 14C\ Contractor Signature IIWORKERS' COMPENSATION DECLARATION �IW! RNIN 3: FAILURF TO FFCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAI TIES AND CIVIL FINES UP TO ON HUN ED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST Or COMPE.XAT:ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. F herLby 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 performance of the work for which this permit is issued. Policy No. e and will intain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the p rformance of the work for which this permit is issued. My workers' compensatiol nsur er and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the performs ce of the work for which this permit is issued, I shall not employ any person in any marine so as to become subject to the workers' compensation laws of California, and agre that, if I should become bile to he workerrsss'' compensation provisions of Section 3700 of the Labor Code, I shall forthwi comply with those prow ions. Signature of Applicant � � Date DECLARATION REGAR G C STRUCTION LENDING AGENCY I hereby affirm under penalty of perjurythat there is a construction lending agency for the performance oftheworkforwhici this permit is issued ( ection 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 cNnty toenter the above -identified property for inspection purposes. AC77ON DATE BY DECLARATION OF COMPLIANCE Mi NCODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 610 AQMD RULE 1403, TITLE40AND PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NO71FICATION ❑ EPA ❑ AQMD TO: PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NORftCATION IS NC PROPOSED DEMOLITION. TAPPLICABLE TO PERMIT FINAL CERTIRCATEOF OCCUPANCYISSUED SIGNATURE: