HomeMy WebLinkAboutF2020-0098 - Permitswr= City of Newport Beach - Building Division FIRE Permit: F2020-0098
100 Civic Center Drive, Newport Beach, CA 92660
w Permit Counter Phone (949)644-3288 Project No : 0438-2020
9a'
Inspection Requests Phone (949)644-3255
Job Address: 511 36TH ST NB
Description: SFR FIRE SPRINKLERS (X2019-0125) 39 HEADS.
Inspector Area: 1
Legal Description:
CANAL SECTION LOT 6 BILK 536(AND SWLY112 LOT 7 BILK
Owner: HOLDINGS GARDEN GROVE SIMPSON Contractor:
Address:. 21 AUTO CENTER SR
FIREPROOF FIRE PROTECTION
536
Architect:
BUEN PARK CA 90621
Address:
1101 KINGSTON DR
Address:
Phone:
LA HABRA CA 90631
Phone:
714.476-5370
Phone:
Applicant: CASEY DENISE
Con State Lic:
876004
State Lic:
Address: 1101 KINGSTON DR
Lic Expire:
04/30/2022
Engineer:
LA HABRA CA 90631
Phone:
Bus Lic:
ST30040107
Address:
Lic Exp Date:
08/31/2021
Phone:
Code Edit :2076
Type of Construction: V -B -SPR
Worker's Compensation
Insurance
State Lic:
Designer: CASEY MONTY
Occupancy Group: R3/U
Carrier:
Policy No:
SECURITY NATIONAL INS
SE C RITY 0
Address: 1101 KINGSTON DR
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
Expire:
02/15/2022
LA HABRA CA 90631
Phone:
No of Stories: 3
No of Units: p
Issued Date: 04/14/2020 Special Conditions:
Setback- Front:
HIGH DENSITY AREA
Flood Zone:
.
Bldg Sprinklers: Y
Rear:
Left:
Right:
FEES
tion Valuation:
$3,300.00
PC Fee :
Overtime PC Fee:
$202.00
$0.00
Fire Residential Alarm PC Fee $0.00
Records Management
Extention Fee :
$0.00
Planning Counter Review: $0.00
:
$4.00
Investigation Fee :
Fs
$0.00n
Planning Zoning PC Fee:$0.00
Check Fee:
mit Fee :
$0.00
Public Works PC Fee : $0.00
$0.00
Permit Fee :
$0.00
$240.00
Public Works Traffic Plan Check Fee; $0.00
$0.00
TOTAL FEE :
$446.00
Plan check Fee $446.00
Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
OTHER DEPARTMENT:
ZONING APPROVAL:
PLAN CHECKED BY::
FIRE APPROVAL:
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
NNER-BUILDER DECLARATION the Contractors'
I hereby affirm under penalty perjury
s Code: Any city Or from
low by the
ve placed
ofounty that requires a pterin alto construct, forthe
s
, demolish,improve)lor repair any structure rpnl ortoaits issuance also cable
also requirext to the althe applicant for
action 7031.5, Business and P
- 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
ofessions 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
It more than five hundred dollars ($500). portions of the work, and the structure is not intended or offered for sale (Section 7044,
]I, as owner of the property, or my employees with wages as their sole compensation, will do ( )all of or ( ) p provided that the
Jsiness 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,
Iprovements 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
(proved for the purpose of sale). sed Contractors to construct the
I I as owner of ply to an owner the
property wham o exclusively contracting
thereon, licen who contracts for the projects with a project censedcContractor pursuant to he Contr ctors' State L censerLaw)s' State License Law does no
uilds or
] 1 am exempt from licensure under the Contractors' State License Law for the following reason:
r sided for at leastYII a signature
ign turrefbelo I acknowledge built aohat" except
ldef fit has not been constructed dence in In its h I must have a by licensed contractors I understand that a ne year rior to copy of the happl cable law, Section 7044tof thehis Business andrmit, I cannot lega y
rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Date
ignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
ovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in fullforce
hereby affirm under penalty of perjury that I am licensed under pr
no effect. Date Contractor Signature
icense Class License No
VORKERS' COMPENSATION DECLARATION
IARNING: 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
O ATTORNEY'S FEES.
;OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AN
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 in
performance of the work for which this permit is issued. Policy No.
71 have 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' compensatio
nsurance carrier and policy number are: Expiration Date
;arrier Policy Number phone #
Jame of Agent
3 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, an agrf
.hat, if 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those
provisions.
Date
Signature of Applicant
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for Lenders Address of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name
By my signature below. I certifyto 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 to enter the above -identified property for inspePri�ction
n urp Owner's or Authorized Agent's Name Date
ACDON DATE BY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
XPIRED
AQMD RULE 1403.
E3i SUBMITTEDASBESTOS NOTIFICATION TO:.
❑ EPA
ANCELLED
[3AQMD
[3 ASBESTOS NORFICA170NISNOT APPLICABLE TO
PROPOSEDDEMOLITION.
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_._._. .n -7A
CERTIFICATE DF I I I I SIGNATURE:
OCCUPANCYISSUED
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