HomeMy WebLinkAboutF2016-0275 - PermitsCity of Newport Beach -Building Division IIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2016-0275
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 6 0 2 7 5 Project No : 1165-2016
0
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 167 SHORECLIFF RD NB Description: FIRE SPRINKLER SYSTEM FOR NEW SFR (126) HEADS(X2013-3405)
Inspector Area:'P RFC S
Owner: WHELAN JOHN
Address: 228 HAZEL DR
CORONA DEL MAR CA 92625
Phone: 949-760-1885
Applicant: MEDINA MARTIN
Address: 705 E. HARRISON ST #200
CORONA, CA 92879
Phone: 800-915-3473
Code Edit : 2013
Type of Construction:
V-B-SPR
Occupancy Group:
R3/S-2
Added /New sq.ft. Bldg:
0
Added/New sq. ft. Garage:
0
No of Stories:
2
No of Units :
0
Flood Zone:
Bldg Sprinklers:
Y
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:
$12,968.00
Legal Description:
N TR 1116 LOT 109
Contractor:
FIRE SPRINKLER SYSTEMS INC
Address:
705 E HARRISON #200
CORONA CA 92879
Phone:
800-915.3473
Con State Lie: 684600
Lie Expire: 02128/2018
Bus Lie:
BT30053356
Lie Exp Date:
12131/2016
Worker's Compensation Insurance
Carrier:
INS CO OF THE WEST
Policy No:
WSD503131400
Expire:
10101/2016
Issued Date:
06/08/2016
Setback- Front:
Rear:
Left:
Right:
FEES
$217.50
Fire Residential Alarm PC Fee
$0.00
Planning Counter Review:
$0.00
Planning Zoning PC Fee
$0.00
$0.00
Public Works PC Fee
$0.00
Public Works Traffic Plan Check Fee;
$260.00
54n50 Plan Check Fee
gFill
Architect: ` $
Address: TOR
Phone: State Lie:
Engineer:
Address:
Phone: State Lie:
Designer: GUERRERO JESUS
Address: 705 E. HARRISON ST #200
CORONA CA 92879
Phone: '
Special Conditions:
$0.00
$0.00
$0.00
$0.00
$0.00
$217.50
Records Management
Fee Due at Permit Issuance
OTHER DEPARTMENT:
PLAN CHECKED BY:: __UL
APPROVAL TO ISSUE: )14
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
$16.00
$0.00
$0.00
$266.00
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 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 (_) 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-Builderwill have the burden of proving that it was not built or
improved for the purpose of sale).
111, 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 property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ I 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.htm1.
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 Secti n 7 Division 3 of the Business_and Professions C e, an my licenPin orce
and effect. f
L cencP -)lass License No Dat 0) Contra n e
WORKERS' COMPENSATION DECLARATION
V kR'IING: 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
CJST �I COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
h.:reb; affirm u.ider pe.ialty of perjury one of the following declarations:
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
Los work for which this permit is issued. Policy No.
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'
ier Pnd policy number are:
Policy Number Expiration Date
16 of Agent
certify that, in the,Ijerformance of the work for which this
if I should becofnlS su¢jegt to the wQrkgt's c6plpensatio
it is iss ed, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
ision of Section 3700 of the Labor Code, I shall forthwith comply with those provisions., /
signature of Appli
IECLARATION RVrkMNG COOTRUCTION LENDING AGE CY
hereby affirm under penalty of perjury that there is a constructio nding agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ender's Name Lender's Address
Iy my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners 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 relatin to build ng construction.
I authorize representatives of this city or cAnLto e*r the aboveiyl I =fi property IT ins ction purposes.
of Property Owner or Authorized
ACTION
DATE
BY
DE RATION OF COMPLIANCE WITH CODE OF
FOROFRCEUSEONLY
FEDERAL REGULATIONS PART 01 OF 7ITLE40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AOMD
PERMITCANCELLED
PERMIT EXTENDED
S N07IRCA77ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CER77FICATEOF
SIGNATURE:
OCCUPANCYISSUED