HomeMy WebLinkAboutF2021-0589 - Permitsst„^ City of Newport Beach -Building Division *F2021-0589`
100 Civic Center Drive, Newport Beach, CA 92660
-.?-. Permit Counter Phone (949)644-3288
v g
FIRE Permit: F2021-0589
Project No : 2747-2021
Inspection Requests Phone (949)644-3255
Job Address: 4000 MACARTHUR BLVD NB St: 1 Ft: 9
Description: COMM FIRE SPRINKLERS (60) HEADS (2) PREACTION SYSTEMS 9TH FL
Inspector Area: FIRE
Legal Description: P BK 114 PG 22 PAR 1
Owner: 4000 MAC ARTHUR L P
Contractor: FIRE PROT SPECIALISTS
Architect:
Address: - 400 S HOPE ST #200
Address: 2810 E MIRALOMA AVE
Address:
LOS ANGELES, CA 90071
ANAHEIM CA 92806
Phone:
Phone: 714-635-6500
Phone: State Lic:
Applicant: ANDERSON ROBERT
Con State Lic: 464915
• °
Engineer:
Address: 2810 E MIRALOMA AVE
Lic Expire: 10131/2022
Address:
ANAHEIM CA 92806
Bus Lic: BT30042894
° • °
e•em°c
Phone: 714/635-6500
Lic Exp Date: 05/3112022
Phone: State Lic:
Code Edit: 2019
Worker's Compensation Insurance
Designer: ANDERSON ROBERT °•°•
°0 °
Type of Construction: 1-A-SPR
Carrier: COMP WEST INS. CO.
Address: 2810 E MIRALOMA AVE
Occupancy Group: B
Policy No: WCV5502952
ANAHEIM CA 92806
Added /New sq.ft. Bldg: 0
Expire: 1210212021
Phone:
Added /New sq. ft. Garage: 0
_I ,.-� � ri
... ° o
No of Stories: 10
Issued Date: 12/01/2021
Special Conditions:
No of Units: 0
Setback -Front:
°
Flood Zone: X
Rear:
° ° •
°
Bldg Sprinklers: Y
Left:
° °
. • ° • ° o
Right:
s_,„
"s
FEES
Construction Valuation:
$7,000.00
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:
$244.00
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$383.50
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$629.50
Plan Check Fee:
$244.00 Fee Due at Permit Issuance :
$385.50
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
DWNER-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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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).
❑ 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).
❑ 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.html.
Signature of W party Owner or Authorized Agent Date
LICUSED CONTRACTOR'S DECLARATION
I-htny affirrn9ung9r'penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000) of Division 3 of the Business and Profe Fd ns Code, a m' license is in full force
and effect.
License Class . License No Date a Contractor Signature
pMKERS' COMPENSATION DECLARATION
NARNING: FAILURE40 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
CO"OF COMPEVATIO% DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
,h&eU affirrlt 811RDenalty of perjuryone of the following declarations:
1 *have and v011 maintain a certificate of consent to self -insure for workers' compensation, issued by the
P?Iance ofihe work for which this permit is issued. Policy No.
. . .
have and Wllt maintain workers' compensation insurance, as required by Section 3700 of the Labor Code,
ITra3ce carrier and policy number are:
vier Policy Number
me of Agent •'O rb q
Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
for the performance of the work for which this permit is issued. My workers'
Date
certify that, in the performance of the work for ich 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 1 should become subject jorttIq workers' om er)qation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. , /
nature of Applicant w �/ Late N r a I f
CLARATION REGARDIN CONSTRUCTIO. LENDING AGENCY
)reby 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 3(97, 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 a�Iawpsrorellearting to building construction.I authorize representatives of this city or county to 7q��rpe. a y for inspection purposes.nature of Prooertv Owner orAuthorized Agent X /`0 �'�1�Print Property Owner's or Authorized Agent's Name ➢`j
AC77ON DATE BY r DECLARATIONOF COMPLIANCE TH COUE OF FOR OFFICE
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
PERMIT EXPIRED AQMD RULE 1467.
❑ I SUBMITTED ASBESTOS N017FICATION TO:.
PERMIT CANCELLED ❑ EPA
PERMIT EXTENDED ❑ AQMD
❑ ASBESTOS N07IRCA77ON IS NOT APPLICABLE TO
PERlN7T FINAL
�i `/L, PROPOSED DEMOLITION.
CERTIFICATEOF
OCCUPANCYISSUED SIGNATURE:
X