HomeMy WebLinkAboutF2021-0265 - Permits,�wr'r, City of Newport Beach - Building Division *F2021-0265* FIRE Permit: F2021-0265
�' 100 Civic Center Drive, Newport Beach, CA 92660
;a 1,}�� Project No : 1447-2021
�' v.. Permit Counter Phone (949)644-3288 1 Pw EC'T® )
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"err«�.+'1' Inspection Requests Phone (949)644-3255
Job Address: 4000 MACARTHUR BLVD NB FL ' wi `_�` ai d Description: COMM FIRE SPRINKLER TI (X2021.0614) RELOCATE 29 HEADS
Inspector Area: FIRE
Legal Description:
P BK 114 PG 22 PAR 1
Owner: 4000 MAC ARTHUR L P
Contractor:
ALL PRO FIRE PROTECTION INC
Architect:
Address: 400 S HOPE ST 9200
Address:
22310 SAN JOAQUIN DR W
Address:
LOS ANGELES, CA 90071
CANYON LAKE CA 92587
Phone:
Phone:
951.244-9836
Phone:
State Lic:
Applicant: ANNA
Con State Lic:
629993
Engineer:
Address: 22310 SAN JOAQUIN DR W
Lic Expire:
12131/2021
Address:
CANYON LAKE CA 92587
Bus Lic:
BT30029935
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Phone: 981-244-9836
Lic Exp Date:
08/3112021
Phone:
State Lic:
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Code Edit : 2019
Worker's Compensation Insurance
Designer:
JOHNSTON JOHN
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Type of Construction: V-B-SPR
Carrier:
OAK RIVER
Address:
22310 SAN JOAQUIN DR WEST
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Occupancy Group: B
Policy No:
ALWCO28545
CANYON LAKE CA 92587
Added /New sq.ft. Bldg: 0
Expire:
03/01/2022
Phone:
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Added/New sq. ft. Garage: 0
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No of Stories: 10
Issued Date: 08/04/2021
Special Conditions:
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No of Units : 0
Setback- Front:
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Flood Zone: X
Rear:
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Bldg Sprinklers: Y
Left:
Right:
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FEES
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Construction Valuation:
$2,900.00
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Building PC Fee,
$0.00
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:
$175.00
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$272.25
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$449.25
Plan Check Fee:
$175.00 Fee Due at Permit Issuance:
$274.25
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
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 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).
1, 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 -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
1, 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 legal)
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.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 wip S ction 7000) of Division 3 of the Business and Pro essions Code, and my license is in full force
and effect. • • • • �pn� v
License Class •....� License No Cat Flog Z Contractor Signaturvy
impt fRS' C=OVPPE�NSATION DECLARATION
W@@RNIT!�L: FAILURE TO EaCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN RED THOUSAND DOLLARS I$'100,0001, IN ADDITION TO THE
GbST Ok POMPENSATJON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
rheMy affirm uildej penalty of perjury one of the following declarations:
• •1 have and w • ilt 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
perfo lance of t4%Work for which this permit is issued. Policy No.
pJ4"A and will"dirttain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensatio
uran ce carrier and policy number are:
afriet • • • • - Policy Number Expiration Date
p�e. jAgent •• Phone#
• 1.0artify that,.io ihE•performa ce 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 agre
that, if I should becorng su j o 1the
nw�orkers'�op/�pp��nn attii�onq ppro'9visions of Section 3700 of the Labor Code, I shall forthwith comply with thosg` p visions
r,
Signature of Applicant I X "' �(ti / r L'CI Y d Datd7C 6 y�
DECLARATION REGA IN CONSTRUCTION LENDING AGENCY
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 cc n o d' ances and state laws relating to building construction.
I authorize representatives of this city or county an a above-identi o f nj�ection purposes. ....I��q ,1� i, ' �� In/1
Signature of PropertyOwner or Authorized Agent Print Propert Owner's or Authorized Agent's Name / l `��'�l/L Y L at ( ! 1 ASBESTOS
ACT(QN DATE BY DECLARATION OF COMPLIANCE WlTN CODE OF FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF Tt7LEdt7AND
A4MD RULE 940J.
PFRMiTEXP1REQ
❑ LSUBMITTED ASBESTOS N071F1CATfON TO:
❑ EPA
❑ AOMD
PERMITCANCELLED
PERMfTEXTENQEQ
P❑ROPOSED
PERMIT FINAL