HomeMy WebLinkAboutF2019-0132 - PermitsCity of Newport Beach - Building Division IIIIUIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIII II
7{ 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 2501 BLACKTHORN ST NB
Inspector Area: 8
Owner: ANTOYAN ALLEN
Address: 1050 W KATELL AVE #J
ORANGE CA 92867
Phone:
Applicant: CASEY MONTY
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone: 714-476-5370
Code Edit : 2016
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
0
Flood Zone:
X
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
$3,700.00
FIRE Permit: F2019-0132
Project No : 0521-2019
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS (37) HEADS (X2017-3763)
Legal Description:
N TR 4893 LOT 84
Contractor:
FIREPROOF FIRE PROTECTION
Address:
1101 KINGSTON DR
LA HABRA CA 90631
Phone:
714-476-5370
Con State Lic:
876004
Lic Expire:
04/3012020
Bus Lic:
BT30040107
Lic Exp Date:
08/31/2019
Worker's Compensation
Insurance
Carrier:
NORGUARD INS CO
Policy No:
MOWC002750
Expire:
0211512020
Issued Date: 03111/2019
Setback- Front:
Rear:
Left:
Right:
FEES
$202.00
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;
$240.00
$446.00
Plan Check Fee
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
$0.00
$0.00
$0.00
$0.00
$0.00
State Lic:
State Lic:
CASEY MONTY
1101 KINGSTON DR
LA HABRA CA 90631
714-476-5370
Records Management
$0.00 Fee Due at Permit Issuance :
PROCESSED BY: '!J ' OTHER DEPARTMENT:
PLAN CHECKED BY::
ZONING APPROVAL:
APPROVAL TO ISSUE:
FIRE APPROVAL:
PERMIT EXPIRES 180 DAYS AFTFR ISSUAMCE OR r.AST VALID INSPECTION
$4.00
$0.00
$0.00
$446.00
VVYIVCK-6UILUCK UCGL.AKA I IUN
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason (a) 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 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 completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
ff 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 property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 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 legall)
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:hftp://www.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 license is in full force
and effect.
License Class License No Date Contractor Signatur
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 OOL S (E100,000(, 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:
1 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
3e*rmance of the work for which this permit is issued. Policy No.
have and will m9ft.qaln 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 ancilpohcY number W%
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 subct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith Comply with those provisions.
of
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�reby affirm under penalty of perjury that there is a truction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
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 toent the above -identified pro arty for inspection purposes.
nature of Property Owner or Authorized Agent < l\ � Print Prmerty Ownoi
or Authorized Agent's NameyL�r eJ Date, —_
ACTION
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It BY
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FOR OFFICE USE ONLY
PERMIT EXPIRED
PERMITCANCECCED
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CERTIFICATE OF
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