HomeMy WebLinkAboutF2018-0339 - Permits9„, pity of Newport Beach - Building Division
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a'4 -100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 8 0 3 3 9
�, Permit Counter Phone (949)644-3288
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Job Address: 410 MARIGOLD AVE NB
Inspector Area: FIRE
Owner: CITY OF NEWPORT BEACH
Address: PO BOX 1768
NEWPORT BEACH, CA 92658
Phone: 9496443141
FIRE Permit: F2018-0339
Project No : 1372-2018,
P1
Inspection Requests Phone (949)644-3255:
Description: COMM "FIRE STATION 5 & BRANCH LIBRARY” FIRE SPRINKLERS 344
Legal Description: CORONA DEL MAR LOT 2 BILK 440(AND LOT 4 BILK 440
Contractor:
WILKES FIRE PROTECTION
Address:
325 EMERSON ST
Lic Expire:
UPLAND CA 91784
Phone:
626-290-0395
Applicant: WILKES CASEY
Con State Lic:
1021905
Address: 325 EMERSON ST
Lic Expire:
12131/2018
UPLAND, CA 91784
Bus Lic:
BT30064620
Phone:
Lic Exp Date:
09/30/2019
Cade Edit : 2016
Worker's Compensation Insurance
Type of Construction: V -B -SPR
Carrier:
STATE COMP. INS
Occupancy Group: A3BR2S2
Policy No:
9216687
Added /New sq.ft. Bldg: 0
Expire:
10/0112016
Added /New sq. ft. Garage: 0
CYPRESS, CA 90630
No of Stories: 2
Issued Date: 09/20/2018
No of Units : 0
Setback- Front:
Fire Plan Check Fee:
Flood Zone: X
Rear:
$0.00
Bldg Sprinklers: Y
Left:
$362.00
Public Works Traffic Plan Check Fee;
Right:
Architect:
"
Address:
Construction Valuation:
Phone:
State Lic:
Engineer:
Building PC Fee:
$0.00
Address:
$0.00 Records Management : -
$8.00
Phone:
State Lic:
Planning Counter Review:
Designer:
CHOWNING SCOTT
Building Extention Fee:
Address:
6307 MT. RIPLEY OR
$0.00
CYPRESS, CA 90630
$0.00
Phone:
714-448-5705
$0.00
Special Conditions:
C asE,F C(pa(,p) a90 - cD,3(?s
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: �. n • • E� °„ , PLAN CHECKED BY::
FIRE APPROVAL: o o `s ` • • APPR.7VA`Ln10 ISSUE:
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PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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FEES
Construction Valuation:
$68,000.00
Building PC Fee:
$0.00
Fire Residential Alarm PC Fee:
$0.00 Records Management : -
$8.00
Building Overtime PC Fee:
$0.00
Planning Counter Review:
$0.00
Building Extention Fee:
$0.00
Planning Zoning PC Fee:
$0.00
Building Investigation Fee:
$0.00
$0.00
Fire Plan Check Fee:
$701.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee :
$362.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$0.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: �. n • • E� °„ , PLAN CHECKED BY::
FIRE APPROVAL: o o `s ` • • APPR.7VA`Ln10 ISSUE:
`. • , •.
•
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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)WNER-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
he 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
lot more than five hundred dollars ($500).
1 I, 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,
3usiness 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
mprovements 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
mproved for the purpose of sale).
7 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
Ipply 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: -
3y 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 legaill
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
)rofessions Code, is available upon request when this application is submitted or at the following Web site:hltp://w .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 Business and Prof sions Code, and my license is in full force
r
Ind effect. 9
.!cense Class License No Date Contractor Signature
YORKERS' COMPENSATION DECLARATION
IARNING: 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 1$100,0001, IN ADDITION TO THE
;OST 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 the following declarations: -
7 I have 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 th
performance of the work for which this permit is issued. Policy No.
have and will Trr(Kayintaln 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'
rance carrier and,dplicy numbeTlgre: , _ A
Date
ne of Agent A I , UI,V -\- rnone rf
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 sjlbject V)he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thoser„ovisions:
mature of Applicant �//!/ Date t - e
CLARATION REI*RDING-CONST/KVCTION LENDING AGENCY
areby affirm under penally of perju at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ider's Name Lender's Address
my signature below, 1 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 ant �e ab-ove�-'dentif! property for inspection purposes. / .�1�
mature of ProDertv Owner or Authorized ADent -7�1 e, -- Print Property Owner's or Authorized Agent's Nam / Ce 9J- e y 'w/ &1CeS DU
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