HomeMy WebLinkAboutF2021-0045 - Permits'TX'hrywN City of Newport Beach - Building Division II IIIII IIIIIII II IIIII IIIIIII III II II
QW100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 t 0 0 4 5
Permit Counter Phone (949)644-3288
Job Address: 4000 MACARTHUR BLVD NB
Inspector Area: FIRE
Owner:
HG NEWPORT OWNER LLC
Address:
101 CALIFORNIA ST #100
SAN FRANCISCO CA 94111
Phone:
Applicant:
JOHNSTON JOHN
Address:
22310 SAN JOAQUIN
CANYON LAKE CA 92587
Phone:
951.244-9836
Code Edit : 2019
Type of Construction:
I-A-SPR
Occupancy Group:
B
Added /New sq.ft. Bldg:
0
Added ]New sq. ft. Garage:
0
No of Stories:
10
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
FIRE Permit: F2021-0045
Project No: 0256-2021
Inspection Requests Phone (949)644-3255
A 0 0 - Description: COMM FIRE SPRINKLERS (49) HEADS (X2020-0923)
Legal Description: P BK 114 PG 22 PAR 1
Contractor: ALL PRO FIRE PROTECTION INC
Architect:
Address: 22310 SAN JOAQUIN DR W
Address:
CANYON LAKE CA 92587
Phone: 951-244-9836
Phone:
State Lie:
Con State Lie: 629993
Engineer:
Lie Expire: 12131/2021
Address:
Bus Lie: BT30029935
_
Lie Exp Date: 0813112021
Phone:
State Lie:
Worker's Compensation Insurance
Designer:
JOHNSTON JOHN
Carrier: OAK RIVER
Address:
22310 SAN KOAQUIN DR
Policy No: ALWCO28645
CANYON LAKE CA 92587
Expire: 0310112021
Phone:
951-244-9836
Issued Date: 02/19/2021
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
FEES
Construction Valuation:
$4,900.00
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:
$215.00
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$337.26
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$554.25
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$554.25
PROCESSED BY: d OTHER DEPARTMENT:
ZONING APPROVAL: _ PLAN CHECKED BY::
FIRE APPROVAL: �" I APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 (_) 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).
❑ 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 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: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 Secti n 70 0) of Division 3 of the Business and Pr sions Code, a d y I nse is In fpll force
and effect �ij 7 f �/
License Class License No Dat rv` Contractor Signatu[2� / P`�
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 DOLLARS (E100,00(i(, 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:
FI 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
erf ance of the work for which this permit is issued. Policy No.
ave 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' compen
ance carrier and policy number are:
ier Policy Number Expiration Date
1e of Agent Phone #
certify that, in the perfo ce of the work f r 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
�su�b' tc the workers' s n r visions of Section 3700 of the Labor Code, I shall forthwith comply with those�prr visic
IatureofApplicantl Y � Datex tl ?, i
I hereby affirm under penally of perjurythat 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 Lenders 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 co y ordinances and at a laws relll ing to building construction.
I authorize representatives of this city or coun t t at V rty for inspection purposes.
Signature of Property Owner or Authorized Aggrit. Print Property Owners or Authorized Agent's Name P l Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE KITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF Tf ILE 40AND
AQMO RULE 1403. -
PERMIT EXPIRED
❑ ISUBMITTEUASBESTOSNOIIFICATIONTO:
❑ EPA
❑ AQMO
-
PERMITCANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOIIFICAAONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
2/
CERTlFICATEOF
SIGNATURE:.
OCCUPANCYISSUED