HomeMy WebLinkAboutF2022-0300 - PermitsCity of Newport Beach - Building Division *F2022-0300*
rTg 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
FIRE Permit: F2022-0300
Project No : 1523-2022
Inspection Requests Phone (949)6A, 75S,
..
Job Address: 916 W BALBOA BLVD NB
Description: MFR FIRE SPRINKLER SYSTEM W/ (35) HEADS.
(X2021-1386)
Inspector Area: 1
Legal Description:
NEWPORT BEACH SEC B BILK 109 LOT 9
Owner: SOCAL CAPITAL INVESTMENT LLC
Contractor:
GUTIERREZ FIRE PROTECTION
Architect:
y-
Q '
Address: 5205 PROSPECT RD #135
Address:
1230 VALWOOD ST
Address:
C)
SAN JOSE, CA 95129
LA HABRA CA 90631
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Phone:
Phone:
562-712-4792
Phone:
State Lic:
, J
Applicant: GUTIERREZ ANOREW
Con State Lic:
1037409
Engineer:
Address: 1230 VALWOOD ST
Lic Expire:
03/31/2024
Address:
M
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LA HABRA CA 90631
Bus Lic:
BT30077631
C
Phone: 562-7124792
Lic Exp Date:
01/31/2023
Phone:
State Lic:
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Code Edit : 2019
Worker's Compensation
Insurance
Designer:
GUTIERREZ FIRE PROTECTION
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Type of Construction: V-B-SPR
Carrier:
EXEMPT
Address:
1230 VALWOOD STREET
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Occupancy Group: R3/U
Policy No:
No employees
LA HABRA, CA 90631
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Added /New sq.ft. Bldg: 0
Expire:
Phone:
562-7124792
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Added /New sq. ft. Garage: 0
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No of Stories: 2
Issued Date: 06/14/2022
Special
Conditions:
HIGH DENSITY ZONE
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No of Units : 0
Setback- Front:
LIQUEFACTION ZONE
Flood Zone: A01
Rear:
(n
Bldg Sprinklers: Y
Left:
M
Right:
FEES
Construction Valuation:
$5,000.00
Building PC Fee :
$222.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
$2.00
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'
$269.00
TOTAL FEE :
$493.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$493.00
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: (� PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
JWNER-BUILDER DECLARATION
1 hereby affix- "rder 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 items)
(Section 7031.5, B1Iciness 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
lhepandit to files 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
Profess'wris Code) or that he or she is exempt from Iicensure 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
n,t mere than five hundred dollars ($500).
D I, 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,
EJsin_ss and Pr9'esaions 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
Imprp^ements are not ;ntended 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
imnroved for tha pu, pose of sale).
n 1, as owner of 6 it Nroperty, 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 property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
Ci I a)n exeri fror,i Iicensure under the Contractors' State License Law for the following reason: I
Rv Fy signature belov' 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 Iegallvl
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 andII
Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html.
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 Code, and my license is in full force
and effect. t{ZZ
License Class License No Date X r i Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: 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.
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 the
oerformance of the work for which this permit is issued. Policy No.
have 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'
rance carrier and policy number are:
Policy Number
of 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
. if I should become subiect to the workers' comoensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
reof Applicant X— �
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 I have provided is correct.
I agree to comply with all applicable city and county ordinances an to laws relating to building construction. f
I authorize representatives of this city or county to ent a e-Identified eFly for inspection purposes.
Signature of Property Owner or Authorized Agent X Print Property Owner's or Authorized Agent's Narri C'.--.� Date CC — (4—Z
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 51 OF TITLE 40 AND
AQMD RULE 1403.
PERMIT EXP,RED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD..
PERMITCANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
p
CERRFiCATECF
SIGNATURE:.
OCCUPANCYISSUEO