HomeMy WebLinkAboutF2020-0220 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Q
Job Address: 101 15TH ST NB
Inspector Area: FIRE
Owner: ANGELO JOSEPH
Address: 610 NEWPORT CENTER DR
NEWPORT BEACH, CA 92660
Phone:
Applicant: MCSTAY MIKE
Address: 27068 LA PAZ RD#212
ALISO VIEJO CA 92656
Phone: 844-737-3473
Code Edit : 2019
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units:
Flood Zone:
Bldg Sprinklers:
VB
U
0
0
INSPECTOR
FIRE Permit: F2020-0220
Project No : 0874-2020
Inspection Requests Phone (949)644-3255
Description: MIXED USE FIRE SERVICE CONNECTION 4" UNDERGROUND
N_:�Da0-Lr) 3
Legal Description:
Contractor:
ALL AMERICAN FIRE SYSTEMS
Architect:
Address:
PO BOX 2306
Address:
MISSION VIEJO, CA 92690
Phone:
714-476-3169
Phone:
State Lie:
Con State Lie:
1034609
Engineer:
Lie Expire:
01/31/2022
Address:
Bus Lie:
BT30072047
Lie Exp Date:
06/30/2021
Phone:
State Lie:
Worker's Compensation
Insurance
Designer:
MCCUTCHEON DON
Carrier:
NATIONAL LIABILITY
Address:
PO BOX 2306
Policy No:
A9WC006925
MISSION VIEJO, CA 92690
Expire:
11/22/2020
Phone:
0 Issued Date: 06/02/2020 Special Conditions:
0 Setback- Front:
Rear:
N Left:
Right:
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FEES
Construction Valuation:
$20,000.00
Building PC Fee:
$0.00
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:
$376.00
Public Works PC Fee :
$82.50
$0.00
Fire Permit as:
$407.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTAL FEE :
$869.50
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$869.50
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -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 items)
(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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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).
❑ 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).
LJ I am exempt from licensure under the Contractors' State License Law for the following mason:
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 thi.
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
Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi.
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 wit Section 7000) of Division 3 of the Business and P fessio s , and y
and effect.
//� _/�7 .License Class C44 C to License No �� �� 6� Date t / Contractor Sig ure
WORKERS' COMPENSATION DECLARATION
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPL YETI TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T USAND DOLLARS (111
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
and
IN ADDITION TO THE
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
3rmance 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' compensa
Ice carrier and policy number are:
Policy Number
to of Agent
certify that, in the pe Hrrance of he work for w ' is permit is
if I should become ubject a orkerspen ion prR�i c
Iature of Aoolicant
Date
employ any person in any manner so as to become subje to the workers' compensation laws of California, and
I of the Labor Code, I shall forthwith comply with those pr visions.
weby affirm undegpenaK�of perjury *9 there is a cyRstruc ding agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name Lenders Address
my signature below, I certify to each of the followi
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
I authorize representatives of this city or coun jVJ
of Property Owner or
state laws relating to building construction.
rspecnon purposes.
Print Property Owner's
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFRCE USE ONLY
FEDERAL REGULATIONS PART 01 OFTITLE40AIVD
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOBFICA770NIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
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hLV2t
CERTIRCATEOF
OCCUPANCYISSUED
SIGNATURE:
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