HomeMy WebLinkAboutF2019-0167 - PermitsCity of Newport Beach - Building Division
a 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 2601 W COAST HWY NB
Inspector Area: FIRE
Owner: CG ENTERPRISES GROUP LLC
Address: 177 E RENO AVE #G3
LAS VEGAS, NV
Phone:
Applicant: REYES AUSENCIO
Address: PO BOX 162
POMONA CA 91769
Phone: 909-868-6517
Code Edit: 2016
Type of Construction: V -B
Occupancy Group: B
Added /New sq.ft. Bldg: 0
Added /New sq. ft. C'tad'ggp: 0
No &Stones, D ° °' 1
No of, Wnitoe o 0
Flood Zoneb OOOOOd
Bldw 9@r#tgers: ° Y
°
OCOflO
O CO 00
D DO
O O 0000
F 2 0 1 9 0 1 6 7�
FIRE Permit: F2019-0167
Project No : 0728-2019
Inspection Requests Phone (949)644-3255
FEES
Description: COMM FIRE -KITCHEN HOOD FIRE SYSTEM'MAMA'S COMFORT FOOD'
Legal Description: TR 919 LOTH NWLY 50 FT SELY
1300 FT
Contractor:
U S AFIRE & SAFETY INC
Architect:
Address:
PO BOX 4893
Address:
$0:00
ORANGE CA 92806
Building.
Phone:
800-248-0098
Phone: State Lie:
Con State Lie:
902448 -
Engineer:
Lie Expire:
08131/2019
Address:
Bus Lie:
BT30066746
$0.00
Lie Exp Date:
04/30/2020
Phone: State Lie:
Worker's Compensation Insurance
Designer: REYES AUSENCIO
Carrier:
MARKEL INS CO
Address: PO BOX 162
Policy No:
mwc0012031
POMONA CA 91769.
Expire:
0910412019
Phone:
Issued Date: .04/0312019
Special Conditions:
Setback- Front:
TOTAL FEE :
Rear:
Plan Check Fee:
$0.00
Left:
Right
/� �f / �I ('
L" / m g 0 —/ – LG I.L�
FEES
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
Fee Due at Permit Issuance : $358.00.
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
C�jnstruction V0IVpggn4
$3,800.00
°BdildLng
PC Fee m
$0.00
Fire Residential Alarm PC Fee:
$0:00
Building.
Overtime PC- Feer
$0.00
Planning Counter Review:
$0.00
°Building Extemtlm Fee :
$0.00
Planning Zoning PC Fee:
$0.00
°Buildinb investigellf)a Fee:
$0.00
Fire Plan Che1k° qe; °
$136.00
Public Works PC Fee:
$0.00
Fire Permit Fee:
$220.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTAL FEE :
f1 $358.00
Plan Check Fee:
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
Fee Due at Permit Issuance : $358.00.
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 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
im roved 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).
❑ 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 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.govlcalaw.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�encing with Section 7000) f Division 3 of the Business and Prof Bions Code, and my license is in full force
and effect. /� -
License Class License No(-�-. �Z- Date `� 11 - Contractor Signature -�✓>
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 ($100,000), IN ADDITION TO THI
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I here affirm under penalty of perjury one of the following declarations:
Stir
self -insure for workers' compensation, issued by the Director ofIndustrial Relations as provided for by Section 3700 ofdksr labor Code, for tl
Policy No.
•••erance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. f%lyyapl;kers' cor ;ensalic /7 �c� Policy Number Expiration Dale
Name of Agent Phone #
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
, if I should become sub act 1 workers' compensation pr s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Iaturre of Applicant nwA Dat
♦T I�.1 DCl�A ICT�I1/�Tlfltl l Lklr lkl! A/9
rreby affirm under penalty of perjurythat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097
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 and state laws relating to building construction.
I authorize representatives of this cit or count tore.the above -identified o fo actionpurposes.
P Y Yy���
nature of Prooertv Owner or Authorized Acent .-- i.1 Print Property Owner's or Authorized Agent's NameeFf' .
; C penq sation la.. o: California, aad ag
•••• • o
Civil Code). ••••• • o
(9 -co
(� ACTION I DATE BY 11 DECLARATIONOFCOMPLIANCEYYITHCODEOF n I FOR OFFICE USE ONLY I
IPERMIT€XPIRED I I I
I PERMIT CANCELLED I I I
PERMITFINAL
CERRFICAT€OF
OCCUPANCYISSUED
I SUBMITTED ASBESTOS NOTIFICATION TO.
❑ EPA
❑ AQMD
❑ ASBESTOS NODFICATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE.