HomeMy WebLinkAboutF2019-0269 - PermitsrD City of Newport Beach - Building Division
a 100 Civic Center Drive, Newport Beach, CA 92660
ty Permit Counter Phone (949)644-3288
.rrik finim ,'
mem•
JoFi A°d°d�®ss:130oBlfiON AVE NB
Injpgcto oArea: FIRE m m
me ucoo - o. m.
Owp@ro ® IRVINE COMPANY
AlJgrV1%:o 550 NEWPORT CENTER DR
Phoee:N�YVPRT QBEACH, CA 92660
° m•
.m
m m 0000
m
Mppli¢amf VILLAFtLAL CHRIS
Add°reapF 3100-E CEDAR ST #10
m ° ONTARIO CA 91761
t'I4drtaa � 9�1$-94b-5055
Code Edit : 201Ac o c c o
Type of Constru0tlbflm V-BSPR
Occupancy. Group: A2
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 0
Flood Zone:.
Bldg Sprinklers: Y
Construction Valuation
Building PC Fee :
Building Overtime PC Fee:
Building Extention Fee:
Building Investigation Fee
Fire Plan Check Fee:
Fire Permit Fee:
Building Permit Fee:
TOTALFEE:
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
iiiiiiiiii II
FIRE Permit: F2019-0269
Project No: 1035-2019
Inspection Requests Phone (949)644-3255
Description: COMM HOOD SUPPRESSION (X2018-3305) "FLOWER CHILD"
Legal Description: PM 326-48 PAR 1 POR OF PAR
Contractor: V FIRE SYSTEMS CORP Architect:
Address: P O BOX 13278 Address:
SAN BERNARDINO CA 92423
Phone: 909-947.5055 Phone: State Lie:
Con State Lic: 779913 Engineer:
Lie Expire: 06/30/2020 Address:
Bus Lie: BT02031803
Lie Exp Date: 02/28/2020 Phone: State Lie:
Worker's Compensation Insurance Designer: VILLAREAL CHRIS
Carrier: INS CO OF THE WEST Address: 3100 E CEDAR ST STE10
Policy No:. WSD6033410023 ONTARIO;'iC 917611 rae ","A OU1 , �
Expire: 04101/2020 Phone: '"
Issued Date: 05/07/2019 Special Conditions: " s ' a
Setback- Front:
Rear:
Left:
Right:
Plan Check Fee:
Records Management: $2.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $358.00
OTHER DEPARTMENT:
PLAN CHECKED BY::
' APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
$1,200.00
$0.00
- Fire Residential Alarm PC Fee :
$0.00
$0.00
Planning Counter Review:
$0.00
$0.00
Planning Zoning PC Fee :.
$0.00
$0.00
$136.00.
Public Works PC Fee:
$0.00
$220.00
Public Works Traffic Plan Check Fee;
$0.00
$0.00
Plan Check Fee:
Records Management: $2.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $358.00
OTHER DEPARTMENT:
PLAN CHECKED BY::
' APPROVAL TO ISSUE:
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 items)
(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 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 thet:m45 not bulk op °
im roved 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 Li: nse•I°aw 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). . • ; ° ° o °
❑ 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] 1 cannt lggalk/
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 Miluslness anq • °
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 ••ac• •° '
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division.3 of the Business and Pr sions Code, and my license is in full fdfce °
and effect. / ...,,, ��'---,,, ��, 111��l���'''t ° • • • • °
License Class [ License No � Date Contractor Signatu , • . ^ ... 0
WORKERS' COMPENSATION DECLARATION • I "•••
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 ($100,000f WADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of thefollowing declarations:
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
ice of the work for which this permit is issued. Policy No.
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' compensa
of Agent
Policy Number 3,q/0 03 Expiration Date 2C90
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 workers' compensation laws of California, and
if I should become subject t%shq workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions.
of Applicant
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).
ender's Name Lender's Address
ly 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 city or county to enterbove-identified property for inspection purposes. /S
l innnture of Prnnertv owner or Authorized ADent 1 X , Print Property Owners or Authorized Agent's Name LAl/l ii
AC77ON DATE BY
ucr_r-slsutrrvlr yr uvmruxrva,c rrrrn 1.yr
FEDERAL REGULATIONS PART 61 OF TITLE40AIVD
AQMDRULE1403.
.
PERMITEXPIRED
I SUBMfTTEDASBESTOS NO7IFICATION TO.
❑ EPA
❑ AQMD
PERA41TCANCELLED
PERA41TEXTFNDED
❑ ASBESTOS NORFICARONIS NOTAPPLICABL.E TO
PROPOSED DEMOLITION.
PERMITFINAL i MD
CERTIFfCATEOF
SIGNATURE.
OCCUPANCYISSUED
Date