The URL can be used to link to this page

Home My WebLink AboutF2020-0288 - Permitsyawn City of Newport Beach -Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIII�III II 100 Civc Center Drive,, Newport Beach, CA 92660 F 2 0 2 0 r <� Permit. Counter Phone (949)644-3288 Job Address: 4910 BIRCH ST NB I SIT F L Inspectorkea: FIRE Owner: OCRC CAPITAL CORP Address: 7 CORPORATE_ PLAZA DR NEWPORT BEACH, CA 92660 Phone: Applicant: HACKBARTH DAN Address: 4721 BOSTON AVE LA CRESCENTA, CA 91214 Phone: 818-248-1774 Code Edit : 2019 Contractor: Type of Construction: III -B -SPR Occupancy Group: B Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 4 No of Units : 0 Flood Zone: X Bldg Sprinklers: Y FIRE Permit: F2020-0288 Project No : 1206-2020 Inspection Requests Phone (949)644-3255 Description: COMM NEW PRE -ACTION SYSTEM FOR COMPUTER RM Legal Description: N TR 8762 LOT 6 Contractor: FALCON FIRE PROTECTION INC Address: 4721 BOSTON AVE �T'1 LA CRESCENTACA 91214 Phone: 818-248-1774 Con State Lie: 958968 Lie Expire: 03/31/2021 Bus Lie: BT30072690 Lie Exp Date: 08131/2021 Worker's Compensation Insurance Carrier: EVEREST DENALI INS Policy No: 5300004284201 Expire: 0211512021 Issued Date: 0811212020 Setback- Front: Rear: Left: Right: Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: S FEES VJ State Lie: �T'1 $3,000.00 M°V��J State Lie: ' J HACKBARTH DAN $0.00 4721 BOSTON AVE $0.00 .Records Management: LA CRESCENTA, CA 91214 Building Overtime PC Fee: 818-248-1774 Planning Counter Review: S PROCESSED BY: `.. 1 „� E., OTHER DEPARTMENT: ZONING APPROVAL: c " ALAN CHECkE9"BY:: m C u`. 0 p 4 f G FIRE APPROVAL: v APPOROt%q,! `'iC1 ISSUE:I ccs PERMIT EXPIRES 160 DAYS A=FTER 1J=ANCF'QR CAST MALID INSPECTION S c -o ao r c „ o c co FEES Construction Valuation: $3,000.00 Building PC Fee : $0.00 Fire Residential Alarm PC Fee : $0.00 .Records Management: .$0.00 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: $547.00 Public Works PC Fee : $0.00 $0.00 Fire Permit as : $267.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $0.00 TOTAL PEE : $814.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $814.00 PROCESSED BY: `.. 1 „� E., OTHER DEPARTMENT: ZONING APPROVAL: c " ALAN CHECkE9"BY:: m C u`. 0 p 4 f G FIRE APPROVAL: v APPOROt%q,! `'iC1 ISSUE:I ccs PERMIT EXPIRES 160 DAYS A=FTER 1J=ANCF'QR CAST MALID INSPECTION S c -o ao r c „ o c co I hereby affirm under penalty of perjury that I am exempt from the Contractors' StaleLicense Law for the. resson(s) Indicated below by the checkmark(s) I have: placednext to the;applicable Items) Section 7031,5, Business and Professions. Code: Any city or county In at requires a permit to construct,: alter, improve,, demolish, or repair any structure, prior to [Is Issuance, alsorequres the applicant for he permit to file a signed statement that he or she is licensedpursuant to the provisions of the Contractots'State License Law (Chapter 9 (commencing with Section 7000) of Division :}'of the Business and professions Code) or that he or she Ts exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031,5: by any applicant: for a permit subjects theappllcanttoa civil penalty of lot more than five hundred dollars ($500). :11, as owner of the property, or my employeeswith wagesas their sole compensation, will do U all of or portionsofthe work, and the structure Is not Intendedoroffered for sale 'Sectlon7044, Wetness 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 propert,', provided that the mprovements 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 mjtroved 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 pply to an owner of property who builds or Improves thereon, and who contractsforthe projects with a licensed Contractor pursuant to the Contractors' State License Law). _I I am exempt from licensure under the Contractors' State. License Law for the following reason:.. ly my signature below 1 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 cermit, I-cannotlegalll ell 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 'rofessions Code, Is available upon raquestwhen this application is aubmitted: or at the following Web site:httpa/www.leginfo.ca.gov/calaw;html, hgnatureofProperty Owner ror Authorized Agent Date -ICENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that I am licensed under provisions of hailer 9 (commencing with Section 70 0)of ivi Ion 3 of the Business and Prof ss q e, and m .tense Is in full force NO effect. License Class C _ R& License No �5 A9 fe8 Date Contractor Signature ` VORKERS' COMPENSATION DECLARATION IARNINr 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 ;OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S PEES. hereby affirm under penally 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 th, sa rmance of the work for which this permit Is issued. Policy No. I 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' compensatior Isurence carder and ry6fiby number are; r3-%10� I D A L1 _ :abler � 9 /+1�i1 . ., PCpc . �Tlb r.n .53( 0bngzFw Expiration Date A I omeofAgent e �C t.y tog -Phone 0 ]I 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 agree iat. If I should become su jso t to the workers' compensation provisions of Section 3700ofthe Labor Code, I shall forthwith comply with those provisions. IgnatureofApplicant�Fe ECLARATION REG DINGNSRUGTION LENDING •AGENCYA Ga �2 2U 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), enders Name Lender's Address Y 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 Ell applicable city and county ordinances and state lawsrelating to building construction, I authorize representatives of this city or coypVA ent -rr tho nhave-Iden(ified Property for Inspection purposes,. _ „�, _ _ , _ ,p. REGULATIONS PART 61 OF TITLE 40 AND AQMD:RULE A®rE YA • • OCCUPANCYISSUED a