HomeMy WebLinkAboutF2018-0274 - Permits$, City of Newport Beach - Building Division 11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1 Jill FIRE Permit: F2018-0274
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 8 0 2 7 4 Project No : 1103-2018
?. Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 40 EBB TIDE CIR NS Description: MFR - FIRE SPRINKLERS, PHASE 6, PLAN 3. LOT 19, 31 HEADS
Inspector Area: 2 Legal Description: MH LOCATED IN SPACE E4 ON AP 424A31-18 ;MARKET= 7613
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Owner: EBB TIDE, LLC - Contractor: ON GUARD FIRE PROTECTION Architect:
Address: 4 PARK PLAZA STE 1000 Address: 6438 ARVILLE ST Address:
IRVINE CA 92614 LAS VEGAS NV 89118
Phone: Phone: 702-966-8021 Phone: State Lic:
Applicant: ON -GUARD FIRE PROTECTION Con State Lic: 950378 Engineer:
Address: 11800 STERLING AVE 12-L Lic Expire: 07131/2018 Address:
RIVERSIDE CA 92503 Bus Lic: BT30051770
Phone: 702-884.6691 Lic Exp Date: 07/31/2018 Phone: State Lic:
Code Edit : 2016 Worker's Compensation Insurance Designer: MIRANDA ALFREDO
Type of Construction: V-BSPR Carrier: EVEREST NATIONAL Address: 11 B00 STERLING AVE 12-L
Occupancy Group: R3/U Policy No: 5300003285181 RIVERSIDE CA 92503
Added /New sq.ft. Bldg: 0 Expire: 02116/2019 Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2 Issued Date: 06/1112018 Special Conditions:
No of Units : 0 Setback- Front: o °
Flood Zone: Rear: ccoc c00000
o ° o
Bldg Sprinklers: Y Left:
Right:
PROCESSED BY:
ZONING APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
FIRE APPROVAL: l � APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
°
FEES
�°°
Construction Valuation:
$1,860.00
0
° °
O°°op° °CO°
°
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
`$4.00
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
°° $000 0
Fire Plan Check Fee:
$0.00
Public Works PC Fee:
$0.00
° ° ° $0.00
Fire Permit as :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$225.00
TOTAL FEE :
$276.50
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$276.50
PROCESSED BY:
ZONING APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
FIRE APPROVAL: l � APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
C
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 (_) 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
im roved 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 legall
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 Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. % � �� , �A�
License Class License No � ( / 1i Contracto4�ignature �6 IV
_
WORKERS' COMPENSATION DECLARATION VV
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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I have andJ11 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
Yra
nceoftfi0brk far which this permit is issued. Policy No.. and WI11,,rn I lfaln 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' compensatioa carrier an policy number are: WC)
arriar� Policy Number Expiration Date
,tame-of Agent ..... Phone #
I certify that, iD 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 agre
116R,4i?4should'tRB8rAg subject
to
the workers' corWensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (�
••W re of I t PAl//V LI`� ( �, D (C)M
BCL i
ECLPeRATIO -. NSTRUCTION LENDING AGENCY
hereby affirm Mgr%nalty 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).
15 Ed tri Name Lender's Address
3y-n11 signalule N e,, 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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county t en er the above-ide ified properly for inspection purposes. i /�
Signature of Property Owne o -Agent Print Propert Owner's or Authoriz Agent s N • `� U Ii
Ii
ACRON DATE BY DECLARATION OF COMPLIANCEIMT CODEOF FOROFFICEUS
FEDERAL REGULATIONS PART 61 OFTITLE40AND
PERMIT EXPIRED AQMD RULE 1403.
❑ t SUBMITTEDASBESTOS NOTIFICATION TOr
PERMITCANCELLED - ❑ EPA
PERMITEXTENDED ❑ AQMD
❑ ASBESTOS NORRCATIONIS NOTAPPLICABL.E TO
PERMITFNVAL I PROPOSED DEMOLITION.
CERTIFICATEOF SIGNATURE.
OCCOPANCYISSOED
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