HomeMy WebLinkAboutF2021-0340 - Permits0ttk T City of Newport Beach - Building Division 111p11111111111111111111111111111p111111111111p1
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 3
4 ^i.'. Permit Counter Phone (949)644-3288
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FIRE Permit: F2021-0340
Project No : 1825-2021
Inspection Requests Phone (949)644-3255
Job Address: 1541 MONROVIA AVE INS
Description: COMM FIRE ALARM FOR MODULAR BUILDING
(17 DEVICES) X2021-1420
Inspector Area: FIRE
Legal Description:
FIRST ADD TO NEWPORT MESA TR
LOT 1014
Owner: CARDEN HALL LLC
Contractor:
BOYD AND ASSOCIATES
Architect:
Address: 1541 MONROVIA AVE
Address:
6319 COLFAX AVENUE
Address:
z
NEWPORT BEACH, CA 92663
NORTH HOLLYWOOD CA 91606
Phone:
Phone:
949-279-5640
Phone:
Stwc:
Applicant: DRISCOLL STEVEN
Con State Lic:
782794
Engineer:
4J
Address: 3151 AIRWAY
Lic Expire:
0813112022
Address:
1"8"1
�
COSTA MESA, CA 92626
Bus Lic:
BT95001855
1 1 .
Phone: 949-279-5640
Lic Exp Date:
10131/2021
Phone:
St ee c: '
Code Edit : 2019
Worker's Compensation
Insurance
Designer:
DRISCOLL STEVEN
Type of Construction: V-B
Carrier:
EMPLOYEE SERV
Address:
3151 AIRWAY
Occupancy Group: E
Policy No:
WLRC6897155A
COSTA MESA, CA 9260
Added /New sc rt. Bldg: 0
Expire:
03101 /2022
Phone:
949-279-5640 ,
Added /New sq. ft. Garage: 0
•+�+
No of Stories: 1
Issued Date: 0812412021
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone: X
Rear:
Bldg Sprinklers: N
Left:
Right:
J
FEES
Construction Valuation:
$10,595.00
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee :
$0.00 Records Management :
$6.00
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:
$202.25
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$288.25
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$496.50
Plan Check Fee :
$496.50 Fee Due at Permit Issuance :
$0.00
PROCESSED BY: \ OTHER. DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indi
;Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, dem
:he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L
Professions Code) or that he or sheis exempt from Iicensure and the basis for the alleged exemption. Any violation of Secti
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 tl
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through E
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor
❑ 1 am exempt from Iicensure 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 y
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I urn
Professions 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
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of
auu elrect.
License Class License No Date
✓ 0RKERS' COIJIPENSATION DECLARATION
NARNING: FAILURE CO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL"
^.OFT dF.COMPENS""ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm ,rde' penalty of perjury one of the following declarations:
J I ha✓e and wil, ,na.ntain a certificate of consent to self -insure for workers' compensation, issued by the Director of
Auraemance of the work for which this permit is issued. Policy No.
ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
nce carrier and pulley number are:
Hof Agent
edify that, in the pl
if I should become
of
Policy Number
ad below by the checkmark(s) I have placed next to the applicable item(s)
Ih, or repair any structure, prior to its issuance, also requires the applicant for
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
work, and the structure is not intended or offered for sale (Section 7044,
oloyees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that it was not built or
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
)n 3 of the Business and Professions C and my license is in full force
Contractor Signature ,O zea
AND 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
work for wh� 's permit is issued, I shall not employ any person in any manner 4o as to become subject to the workers' compensation laws of California, and
kers' com nsatio provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro yfs ions.
n.Ee F 4` t
CLARATION REGARDING CORSTRUCTION LENDING AGENCY
�reby 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 ordirlpl7Ces�and (ate laws rel uilding construction
I authorize representatives of this city or county to egnter t bo Ide tif' rep
for inspection purposes.
permit is issued (Section 3097, Civil Code).
ACTION
DATE
BY
DECLARATION OF COMPLIANCE M T
CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 51 OF
AQMD RULE 1401
TITLE 40 AND
PERM LT EXPIRED
❑ I SUBMI TIED ASSES TOS N017FIC
❑ EPA
❑ AQMD
ATION TO:
PER,YR TCANCELLED
PERMIT EXTENDED
El ASBESTOS NOTIFICATION IS NO
PROPOSED DEMOLITION.
APPLICABLE TO
PERMIT FINAL
CERT7FICA7F OE
SIGNATURE:
OCCUPANCYISSUED