HomeMy WebLinkAboutF2017-0439 - PermitsS j/ of R��w port Beach -Building Division 111p111111111p111111111p1111111p11111p111111111 11 FIRE Permit: F2017-0439
100 Civic Center Drive; Newport Beach, CA 92660 F 2 0 1 7 0 4 3 9 Project No: 1832-2017
F — Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 4301 JAMBOREE RD NB Description: COMM - FIRE SPRINKLERINEW APT BLDG "NORTH BLDG"!.4537 HEADS
Inspector Area: FIRE Legal Description: N TR 7953 LOT 2
Owner: SHOPOFF GROUP LP
Contractor:
SUNDANCE FIRE PROT
Address: 2 PARK PLAZA, STE 700
Address:
3225 E POST RD
IRVINE CA 92614 -
LAS VEGAS CA NV 89120
Phone: 949-417-1867
Phone:
702-458-8600
Applicant: ALLEN/SUNDANCE FIRE PROTECTION
Con State Lie:
805026
Address: 1060 N. BATAVIA ST
Lie Expire:
0713112018
ORNAGE COUNTY, CA 92867
Bus Lie:
BT30060139
Phone: 714-639-3170
Lie Exp Date:
08131/2018
Code Edit: 2016
Worker's Compensation Insurance
Type of Construction: VA -IA -SPR
Carrier:
TRAVELERS PROP
Occupancy Group: R2/S2
Policy No:
UBOK418002
Added /New sq.ft. Bldg: 0
Expire:
11112/2018
Added /New sq. ft. Garage: 0
$362.00
Public Works Traffic Plan Check Fee;
No of Stories: 7
Issued Date: 03/22/2018
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
TOTAL FEE :
Bldg Sprinklers: N
Left:
$701.00 Fee Due at Permit Issuance :
$460.00
Right:
Architect:
Address:
Phone: State Lie:
Engineer: JACOBS SCOTT
Address: 8100 W SHARA STE e•.• $ ,+°",
LAS VEGAS NV 89117 • m e e
Phone: 702-313.9393 State Lie: C-060079-
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Designer:
Address: m ° • °
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Phone: °O °
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Special Conditions:
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PROCESSED BY: r OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY:: C/
FIRE APPROVAL: APPROVAL TO ISSUE:_
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$751,300.00
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
$42.00
Building Overtime PC Fee:
$0.00
Planning Counter Review:
$0.00
Building Extention Fee:
$56.00
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 :
$1,161.00
Plan Check Fee :
$701.00 Fee Due at Permit Issuance :
$460.00
PROCESSED BY: r OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY:: C/
FIRE APPROVAL: APPROVAL TO ISSUE:_
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -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
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 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 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 legally
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.gov/calaw. html.
Signature of Pro rty Owner or Authorized Agent Date
LICEN§ED COMTMCTOR'S DECLARATION
I•herabyaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit ection 7000) of Division 3 of the Business/andr fes ions Code, and my lic is in full force
and effetat.
6itens9,Class License No Date 3 ;zz-iii Contractor Signature
PVOARERS' CQMP,ENSATION DECLARATION
JFXPNLvv, FAILURE tq SE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOO E HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
ROSTUF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
.1waby affirm ander �Jnalty of perjury one of the following declarations:
31•Mave and wild 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 thr
der o msnce of the work for which this permit is issued. Policy No.
��ave and viiilild1Qain 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' compensation
hS ia; carrier anp policy number are:
Vivre? • ' _ • Policy Number Expiration Date
of Agent Phone #
certify that, in the perfo ance of the work for which this per Is issued, I shall not employ any person in any manner so as to become subje to the workers' compensation laws of California, and
if I should become s/�yb�yle t to/tl�e workers' compensation r Isions of Section 3700 of the Labor Code, I shall forthwith comply with those p visions.
iature of ADolicant / ; /Illus% 1.9 /i®�� D J—,;�g^1,6
hereby affirm under kenalty 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
y 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 cou/p'�'y' ordinances and state IV relating to building construction.
I authorize representatives of this city or county/�(o t e above-identif' property for inspection purposes. 22 r _ //�>
ianature of Property Owner or Authorized Aoent / S� /�% /ld..,m. Print Property Owner's or Authorized ADent's Na �AI l3 /.f�.t� �/ GG Datd Z
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PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
FEDERAL REGULATIONS PART 61 OFTITLE40AND
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