HomeMy WebLinkAboutF2021-0020 - Permits"'1"°t� City of Newport Beach - Building Division I IIIIIIIIIII IIIIIIIII IIIII�IIIIIIIIIIIIIIII II FIRE Permit: F2021-0020
` 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 0 2 0 Project No : 0112-2021
F.; Permit Counter Phone (949)644-3288
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`�+zrrrru�'S' Inspection Requests Phone (949)644-3255
Job Address: 114 MC FADDEN PL NB
Description: COMM UNDERGROUND. FIRE LINE "BAJA SHARKEEZ" X201941130
Inspector Area: FIRE
Legal Description: P BK 79 PG 50 PAR 1
Construction Valuation:
$3,500.00
0
Owner: FAZZI MICHAEL TR
Contractor:
CAL TECH FIRE PROTECTION INC
Architect:
$0.00
0
Address: 1000 W OCEANFRONT
Address:
3745 ALTURA AV
Address:
$0.00
Planning Counter Review:
NEWPORT BEACH CA 92661
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LA CRESCENTA CA 91214
Building Extention Fee :
$0.00
Planning Zoning PC Fee :
Phone:
Phone:
213-798-1966
Phone:
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(Atate Lie:
Applicant: KIM YUN
Con State Lie:
1049420
Engineer:
U
Public Works PC Fee:
Address: 3745 ALTURA AVE
Lie Expire:
06/30/2022
Address:
$425.00
Public Works Traffic Plan Check Fee;
LA CRESENTA CA 91214
Bus Lie:
BT30037950
Building Permit Fee :
$0.00
C
Phone: 310-345-4117
Lie Exp Date:
01/31/2022
Phone:
$915.00
$-tete Lie:
$318.00
Fee Due at Permit Issuance :
$597.00
Code Edit :2019
Worker's Compensation Insurance
Designer:
Type of Construction: V -B -SPR
Carrier:
SECURITY NATIONAL INS CO
Address:
Occupancy Group: U
Policy No:
SWC1282549
Added /New sq.ft. Bldg: 0
Expire:
04130/2021
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Issued Date: 02/18/2021
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: N
Left:
Right
_.
.
PROCESSED BY: OTUR57@PARTMENT:
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ZONING APPROVAL: '> °o , m ° ° ° °PL°9A Ciif-tKED BY::
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FIRE APPROVAL: APPROVAL TO ISSUE:
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PERMIT EXPIRES 189 D'AYS, i'1F7oEI: IS&UANGE Orf LAST VALID INSPECTION
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FEES
Construction Valuation:
$3,500.00
Building PC Fee:
$0.00
Fire Residential Alarm PC Fee :
$0.00
r - kaco;ds Management:
$0.00
Building Overtime PC Fee:
$0.00
Planning Counter Review:
$0.00
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Building Extention Fee :
$0.00
Planning Zoning PC Fee :
$0.00
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Building Investigation Fee:
Fire Plan Check Fee:
$0.00
�''
$0.00
$318.00
Public Works PC Fee:
$172.00
$0.00
Fire Permit Fee :
$425.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$915.00
Plan Check Fee:
$318.00
Fee Due at Permit Issuance :
$597.00
PROCESSED BY: OTUR57@PARTMENT:
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FIRE APPROVAL: APPROVAL TO ISSUE:
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PERMIT EXPIRES 189 D'AYS, i'1F7oEI: IS&UANGE Orf LAST VALID INSPECTION
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)WNER-BUILDER DECLARATION s
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
iot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
iusiness 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
Tlprovements 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
reproved 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
Ip ly 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:
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 legally
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 Professions de, and my license is in full force
Ind effect. /I
.icense Class (�� License No Y l ��/ C% Dat - 2 Contractor Signatur L y
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOO HUNDRED THOUSAND DOLLARS ($100,000), 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:
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 IN
e ormance 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
Date
ne of Agent -inone s
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 subject to th5e*orkers' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicar Y l 417r Dat& 2"
CLARATION REURDIN�CONSTRUCTIVIT LENDING AGENCY
=.reby affirm under penal y of perjury that there is a construction lending agency for the performance of the work for which this permit is
Idler'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 ordin,a� ces and state laws relating to building construction.
I authorize representatives of this city or county,)o entgYe ab identified property for inspection purposes.
(Section 3097, Civil Code).
ACTION DATE I BY DECLARATION OFCOMPLANCE WITH CODEOF FOR OERCE USE ONLY
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