HomeMy WebLinkAboutF2018-0458 - Permits®1,o City of Newport Beach - Building Division IIII
100 Civic Center Drive, Newport Beach, CA 92660 P IIIIIIIIIIIiIIIIIIIII�III�IIIIIIIIIIIIIIIII
.a Permit Counter Phone (949)644-3288
Job Address: 1223 E BALBOA BLVD NB
Inspector Area: 1
Owner: ARRACHE RONALD B
Address: PO BOX 2143
LANCASTER, CA 93539
Phone:
Applicant: CASEY DENISE
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone: 714.476-5370
Code Edit: 2016
Type of Construction: V -B -SPR
Occupancy Group: R31U
Added /New sq.ft. Bldg: 0
Added/New sq. ft. Garage: 0
No of Stories: 3
No of Units : 0
Flood Zone: 0.2
Bldg Sprinklers: Y
FIRE Permit: F2018-0458
Project No: 1969-2018
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS (35) HEADS (X2017-2022)
Legal Description: BALBOA TR EAST SIDE ADD BLK 20 LOT 11
Contractor: FIREPROOF FIRE PROTECTION Architect:
Address: 1101 KINGSTON DR Address:
Issued Date: 08120/2018
Setback- Front:
Rear:
Left:
Right:
Phone:
Engineer:
Address:
r
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State Lic:
Phone:
LA HABRA CA 90631
Phone:
714-476-5370
Con State Lic:
876004
Lic Expire:
04/30/2020
Bus Lic:
ST30040107
Lic Exp Date:
.08/3112019
Worker's Compensation
Insurance
Carrier:
NORGUARD INS CO
Policy No:
MOWC901180
Expire:
0211512019
Issued Date: 08120/2018
Setback- Front:
Rear:
Left:
Right:
Phone:
Engineer:
Address:
r
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State Lic:
Phone:
State Lic:
Designer:
CASEY MONTY
FEES
Address:
1101 KINGSTON DR
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LA HABRA CA 90631
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Construction Valuation:
Phone:
714.476.5370
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Special Conditions:
REVISED 11-19-18
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Building Overtime PC Fee:
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Planning Zoning PC Fee :
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PROCESSED BY:
OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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Construction Valuation:
$3,200.00
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Building PC Fee:
$190.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
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Building Overtime PC Fee:
$0.00
Planning Counter Review:
$0.00
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Building Extention Fee:
$0.00
Planning Zoning PC Fee :
$0.00
Building Investigation Fee:
$0.00
$0.00
Fire Plan Check Fee:
$0.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit as:
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$225.00
TOTAL FEE :
$421.00
Plan Check Fee:
$421.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: 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)
lection 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 (_) 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
n roved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 9044, Business and Professions Code: The Contractors' State License Law doeS nui
pply 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:
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 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
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bus l ass and Professions Code, and my license is in full force
nd effect.
icense Class License No ate Contractor S' lure
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE i0 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE TO CRIMINAL PENALTIES AND CIVIL FI P TO ONE HUNDRED THOUSAND Dib RS ($100,000), IN ADDITION TO THE
OST OF COMPENSRIftVgAMAGES AS PROVIDED FOR IN SECTION alai OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
11ejeby affirm u%der penalty of perjury one of the following declarations:
1 have and velli maintain a certificate of consent to self-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thl
ftrt%nce of the•work for which this permit is issued. Policy No.
and wit �n slain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
carrier and policy number are:
Policy Number
�of-Agent •+•• r
edify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to becc
if I; hould b$gpgV.4Ibjqct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with
SkARAVOfd REGARDING CONSTRUC�fIION LENDING AGENCY
�reby affir • eT enalty of perjury that there is a construction lending agency for the performance of the work for which this permit
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 aunty ordinances and state laws relating to building construction.
I authorize representatives of this city or cou t to enter t above -Identified property for inspection purposes. �
mature of Property Owner or Authorized Agent �� Print Property Owner's or Authorized A9E
Date
to the workers' compensation laws of California, and
(Section 3097, Civil Code).
A[DONDATE BY
DECLARATION OF OMPMANCEWtTH CO OF�
FOR OFFICE SEO Y
F€DERAL REGULATIONS PART 61 OF TI R.E40AH
AQMDRULE 1403.
PERMIT€iCPIA€B
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