HomeMy WebLinkAboutF2021-0501 - Permits�1,wrrr4,�. City of Newport Beach - Building Division
.{�'^�� 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 2024 NAUTILUS LN NB
Inspector Area: 3
Owner:
MOORE SCOTT
Address:
2024 NAUTILUS LN
NEWPORT BEACH, CA 92660
Phone:
Applicant:
SHIELD FIRE PROTECTION
Address:
27052 LOST COLT DRIVE
LAGUNA HILLS CA 92653
Phone:
949-378-7877
Code Edit : 2019
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
1
Flood Zone:
X
Bldg Sprinklers:
Y
`F2021--0501*
FIRE Permit: F2021-0501
Project No : 2480-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS CAP 8 (E) HEADS; REPLACE 6 HEAD, &
Legal Description:
N TR 3763 LOT 75
Contractor:
SHIELD FIRE PROTECTION
Architect:
Address:
29391 VALERIO CT
Address:
LAGUNA NIGUEL, CA 92677
Phone:
949-388-6556
Phone: State Lic:
Con State Lic:
916743
Engineer:
Lic Expire:
0613012022
Address:
Bus Lic:
BT30077002
Lic Exp Date:
1013112022
Phone:
State Lic:
Worker's Compensation
Insurance
Designer:
SHIELD FIRE PROTECTION
Carrier:
TECHNOLOGY INSURANCE CO INC
Address:
29391 VALERIO CT
Policy No:
TWC4003709
LAGUNA NIGUEL, CA 92677
Expire:
07/15/2022
Phone:
949-378-7877
Issued Date:
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
FEES
Construction Valuation:
$1,500.00
Building PC Fee :
$222.00
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
$0.00
Building Investigation Fee :
Fire Plan Check Fee:
$0.00
$0.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$269.00
TOTAL FEE :
$495.00
Plan Check Fee :
$495.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
U-5
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
IWNER-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
ie 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
'rofessions 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
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved for the purpose of sale).
1 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
poly 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:
ly 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
ell a structure !:tX. 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 request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw. html.
'igr.s:ure of PiopertY Owner or Authorized Agent Date
.ICENSED CON i RACTOR'S DECLARATION
hereby affirm u.lder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prof salons Code, and my license is in full force
nu affect. ` r �I
icel.se Class . _ License No Date XC ( 110 - Z6L ( Contractor Signature
CORKERS' COMPENSATION DECLARATION
6.MN,NG: FAILURE "V ^,ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($106,a00), IN ADDITION TO THE
PST 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:
I have and V111 mnintain 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 IN
a-fm,ance of the work for which this permit is issued. Policy No.
nave and will makitain 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'
"ante carrier and policy number are:
Policy Number Expiratic
of Agent Phone #
Date
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
if I should become subject tgtlje worke,%9 ompeoWflon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of Applicant
'Lp -'7—z Z
DECLARATION REGARDING CONSPRO DN-LENDING AGENCY
I hereby affirm under penalty of perju 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 county ordinane and state laws relating to building construction.
I authorize representatives of this city or county to enter t dove -I if property for inspection purposes. �/ .— Y r
Signature of Property Owner or Authorized Agent k 1 % Print Property Owner's or Authorized Agent's Name >< CC45 G �! �'L'11 Zc U-It Date
ACTION
DATE
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ ]SUBMITTED ASBESTOS N071FICATIONTO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
ESL -ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
U 12(t
D
CERP 4CA TE OF
OCCUPANCYISSUED
SIGNATURE: