HomeMy WebLinkAboutF2019-0620 - PermitsCity of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIIIIIII�IIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 5000 BIRCH ST NB St: 1 FI: 4 Unit: 4400
Inspector Area: FIRE
Owner:
JOHN HANCOCK LIFE
Address:
865 S FIGUREROA ST, STE 3320
Address:
LOS ANGELES CA 90017
Phone:
SANTA ANA CA 92701
Applicant:
FIRE SAFETY FIRST
Address:
1170 E FRUIT ST
Lie Expire:
SANTA ANA CA 92701
Phone:
711-248-1260
Code Edit: 2016
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
Construction Valuation:
V -B -SPR
B
0
0
FIRE Permit: F2019-0620
Project No: 2516-2019
Inspection Requests Phone (949)644-3255
Description: COMM - TI (INSTALL (2) SPEAKER STROBES, TIE INTO EXTG
Legal Description:
P BK 181 PG 13 PAR 5
Contractor:
FIRE SAFETY FIRST
Address:
1170 E FRUIT ST
$0.00
SANTA ANA CA 92701
Phone:
714-836-4600 X137
Con State Lic:
599761
Lie Expire:
08131/2020
Bus Lie:
BT00009906
Lie Exp Date:
06/30/2020
Worker's Compensation Insurance
Carrier:
CYPRESS INS CO
Policy No:
BRWC916820
Expire:
11/01/2020
4 Issued Date: 12/1312019
0 Setback- Front:
Rear:
Y Left:
Right:
Building PC Fee :
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Fee:
Fire Plan Check Fee:
Fire Permit Fee :
Building Permit Fee
TOTAL FEE
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
FEES
$2,000.00
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Xaat,C; - Lq-2 (0
State Lie:
State Lie:
Designer: MORGAN JAKOB
Address: 3161 MICHELSON DR #140
IRVINE CA 92612
Phone:
Special Conditions: �®
-1iLt- aa�-ia d
$0.00
Fire Residential Alarm PC Fee: $0.00 Records Management:
$0.00
$0.00
Planning Counter Review: $0.00
$0.00
Planning Zoning PC Fee : $0.00
$0.00
$0.00
$191.00
Public Works PC Fee: $0.00
$0.00
$226.00
Public Works Traffic Plan Check Fee; $0.00
$0.00
$417.00
Plan Check Fee : $191.00 Fee Due at Permit Issuance :
$226.00
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
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�PERY17,;E),,'PIRES
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98 ,DAY'S AFTER ISSUANCE OR LAST VALID INSPECTION
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LDER 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, priorto its issuance, also requires the applicant for
is 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 U all of or (_) 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
nproved 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
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 legall,
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 Business and Pro io d my license is in full force
nd effect.
icense Class License No Dat Contractor Signatur
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSA LLARS ($700,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
Mrmance 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'
carrier and policy number are:
Policy Number
of Agent
Date
I certify that, in the performance oft work for ich 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 agree
t, if I should become subject totrIff w ke ' c en ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date je 12- 3 • 19
CLARATION REGANDLNGVCONSTRUCTION L ING AGE011Y T
areby affirm under penalty of perjury that there is onstruction 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, 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 ordi nc s sta la
I authorize representatives of this city c count)%to erg! rd li i ifiec
ACTION I DATE
IPERMITEXPIR€D I I I
PERMlTCANC€'CEO
rPERMIT EXTENO€0
PERMIT FINAL
CERTIRCATE OF
OCCUPANCYISSUED
us relating to building construction.
property for inspection purposes.
er Print Prooertv Owner's or Authorized
FEDERAL REGULATIONEJ14RrT-U Of Wf@E J04ND ... •••
AQMO RULE 1403.
❑ t SUBMITTEDASBEJtOS yOVF?CA7:ON TD; .:
❑ EPA . • . ••' • '
❑ AQMD
❑ ASBESTOS N017RCA770NIS NOT APPLICABLE TO
PROPOSED DEMOLITION. ••• ;" '
SIGNATURE. • ' ' "
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