HomeMy WebLinkAboutF2019-0438 - Permitsa
City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII FIRE Permit: F2019-0438
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 9 0 4 3 8 Project No :1701-2019
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 2135 WESTCLIFF DR NB St: 1 FI: 1 Unit: 102 Description: COMM - FIRE SPRINKLERITI 50 HEADS (X2019-1449)
1701-2019
Inspector Area: FIRE Legal Description:
Owner: HANKEY INV CO LP
Contractor:
M J FIRE PROTECTION
Address: 2043 WESTCLIFF DR UNIT A
Address:
18712 DALLAS AVE
NEWPORT BEACH CA 92663
Fire Residential Alarm PC Fee: $0.00 Records Management:
RIVERSIDE CA 92508
Phone:
Phone:
951-789-9360
Applicant: HOLLAND JIM
Con State Lic'
1013877
Address: 18712 DALLAS AVE
Lic Expire:
0513112020
RIVERSIDE CA 92508
Bus Lic:
BT30068293
Phone: 951-789-9360
Lic Exp Date:
07/31/2020
Code Edit : 2016
Worker's Compensation Insurance
Type of Construction: V -B -SPR
Carrier:
EXEMPT
Occupancy Group: BIM
Policy No:
OTHER DEPART ENT:
Added /New sq.ft. Bldg: 0
Expire:
Added /New sq. ft. Garage: 0
PLAN CHECKED
No of Stories: 2
Issued Date: 07/30/2019
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: N
Left:
Right:
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
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
INSPECTOR
State Lic:
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PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID
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FEES
$8,300.00
$0.00
Fire Residential Alarm PC Fee: $0.00 Records Management:
$4.00
$0.00
Planning Counter Review: $0.00
$0.00
Planning Zoning PC Fee: $0.00
$0.00
$0.00
$236.00
Public Works PC Fee: $0.00
$0.00
$323.00
Public Works Traffic Plan Check Fee; $0.00
-------
$0.00
$563.00
)
Plan Check Fee: $0.00 Fee Due at Permit Issuance :
$563.00
OTHER DEPART ENT:
S
PLAN CHECKED
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID
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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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do `) 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
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 toanowhar of properly who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ Lam exempt.from IiGensure 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 legall)
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:hltp://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED COKTRACTOR'S DECLARATION
I hereby affirm Ifni/g�; eenalty of perjury that I am licensed under provisions of ^C7hapter 9 (commencing with Section 7000) of Division 3 of the Business and Profe ions Co c e, an lic (tas is in full force
4rld.e:e't. 'l-'�f �0�3b ! / Date 'T 9
License.Class b License No I 2,n 101 Contractor Signature
VqRKERS' d6MPENSATION DECLARATION
RARMMG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 41DUSAND DOLLARS ($100,000), IN ADDITION TO THE
CAST qp COMPENDA TIOW DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. _
Eh2rP4ftifirm ander penalty of perjury one of the following declarations:
®•I -leave anciJili'm'antain 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 th
perfarolance of tFM Mrk for which this permit is issued. Policy No.
n
F'J; hAte 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' compensatioi
Insurance carries ar4ablicy number are:
Oaslfee:r. Policy Number Expiration Date
of Agen4 - • : 1 11..,.
tify that, in the pertormannrAee of the work or w 'ch 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
I should become subject he worker ' co/p p n atio provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Ire of Applicant LO I cl Date>O o/I c1
hereby affirm under penalty orjury 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 p Lender's Address
y my signature below, I certify to each of the following: I I f
I am the property owner or authorized to act on the property owner's behalf. 30ir Q5 4t I
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county or Inances an t t laws relating to building construction.
I authorize representatives of this city or county t =the I led property for inspection purposes.
.:,..,�f— ..f o.. arf%o n,.,nor nr A,nhnrlvcrl Anc� Print Prooertv Owners or Authorized Agent's Na
ntrA _1
ACTION DATE BY DECLARATIONOF COMPLIANCEWTTHCODEOF V FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OFTITLE40AND
PERMITEXPIRED AOMD RULE 1463.
tSUBMITTEDASBESTOSN071FICATIONTO:
PERMITCANCELLED ❑ EPA
❑ AQMD
PERMIT EXTENDED
❑ ASBESTOS NOTiFLCATIONIS NOT APPLICABLE TO
PERMITFINAL �� M V� PROPOSEODEMOUTION.
CERTIFICATE OF
SIGNATURE:
OCCUPANCYISSUED