HomeMy WebLinkAboutF2021-0085 - PermitsCity of Newport Beach - Building Division *F2021-0085* FIRE Permit: F2021-0085
a
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288 Project No: 0501-2021
Inspection Requests Phone (949)644-3255
Job Address: 620 NEWPORT CENTER DR NB St: 1 FI: 2 Unit: 200 Description: COMM FIRE ALARM TI (X2021-0553) "STUART KANE" 18 DEVICES
Inspector Area: FIRE Legal Description: P BK 295 PG 33 PAR 1
Owner: 620 NCD LLC L
Contractor:
SIMPSON DAVID CONST CO INC
Architect:
@ N ��"� pm.,.
Address: PO BOX 2450
Address:
17177 GILLETTE AVE #A
Address:
6
' r `--'
- NEWPORT BEACH, CA 92658
Construction Valuation:
IRVINE CA 92614
Phone:
Phone:
949-250.1348
Phone:
State Lic:
Applicant: YAM MARK
Con State Lic:
381149
Engineer:
$0.00 Records Management:
° °$0.00
Address: 4675 MACARTHUR CT #100
Lic Expire:
03/31/2021
Address:
$0.00
0...0.
NEWPORT BEACH CA 92660
Bus Lic:
ST00006013
Planning Zoning PC Fee:
$0.00
°
Phone: 949.863-9434
Lic Exp Date:
06130/2021
Phone:
State Lic:
$0.00
Code Edit : 2019
Worker's Compensation Insurance
Designer:
TAYLOR RICK
$0.00
Type of Construction: I -A -SPR
Carrier:
OAK RIVER
Address:
2246 LINDSAY WAY
$0.00
Occupancy Group: B
Policy No:
DAWC015650
$0.00
GLENDORA CA 91740
.....
Added /New sq.ft. Bldg: 0
Expire:
05101 /2021
Phone:
Plan Check Fee:
° ....
Added /New sq. ft. Garage:
No of Stories: 16
Issued Date: 03126120211
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: Y
Left:
Right:
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
�`0
00000
FEES°
Construction Valuation:
$5,936.00
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
° °$0.00
Building Overtime PC Fee:
$0.00
Planning Counter Review:
$0.00
0...0.
°..°°
Building Extention Fee :
$0.00
Planning Zoning PC Fee:
$0.00
°
Building Investigation Fee :
$0.00
$0.00
Fire Plan Check Fee:
$200.50
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$286.50
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$487.00
Plan Check Fee:
$200.50 Fee Due at Permit Issuance :
$286.50
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
r . 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 (_) 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 Cade: 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 entirely 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.govtcalaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I 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! ss and Pr a sions Cod Rd �ense is in full force
and effect.
License Class License No Da Q5 Contragnature
WORKERS' COMPENSATION DECLARATION vi I
WARNING: 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 ($700,000), IN ADDITION TO THE
COST OF COMPENV*1'Ib bp.MAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Iherebyaffrm unUQPpenalty of perjury one of the following declarations:
....
' 1 ha0e and LilFmsintain 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
orrRance of Tie Ali k for which this permit is issued. Policy No.
lave and wit mailain 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' compensatiol
fli carrier and policy number are:
Carrlibf Policy Number Expiration Date
•4grify that, in the performa ce f the work f which t s ermit is issued, I shall not employ any person in any manner so as to became subject to the workers' compensation laws of California, and
if 6 hould h pe subject he workers' m s lo provisions of Section 3700 of the Labor Code, I shall forthwith comply with tho provisiogqs.
Ireby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil o e).
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 prope owner's behal
I have read this application and the information I have pr Wd' d is correct �/- pt,I n [`
I agree to comply with all applicable city and county obi PASS and stat laws relatin building construction. (�t p A� 4�' �:`'
I authorize representatives of this city or coogtyso ente ar,2y ig prop
or inspection purposes.
ACTION DATE BY
Lc'•-r-/aIi IM IT Vr Ivmruwev.L r., Ia:---- —, -
FEDERAL REGULATtONSPART 69 OF TITLE 40 AND
AQMD RULE 9403.
❑ ISUBMITTEDASRESTOS NORFICATIOL'T TO:.
❑ EPA
❑ AQMD
PERMIT EXPdRED
PERMITCANCEELED
PERMIT E#TENDED
ASBESTOS RORRCAROMISMOT APPLICABLE TO
PROPOSED DEMOLITION. -
SIGNATURE:
PERMIT FINAL 3 ( 0 Vay2A
CERTIFIC4TEOF
OCCUPANCYISSUED