HomeMy WebLinkAboutF2021-0137 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII FIRE Permit: F2021-0137
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 1 3 7 Project No : 0807-2021
w ', Permit Counter Phone (949)644-3288
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`c�tlra5i4 Inspection Requests Phone (949)644-3255
Job Address: 1083 NEWPORT CENTER DR NB St: 1 FI: 1 Unit: A Description: COMM FIRE ALARM (3 DEVICES) X2020-2759
Inspector Area: FIRE
Owner: IRVINE CO
Address: 550 NEWPORT CENTER DR
NEWPORT BEACH, CA 922660
Phone:
Applicant: INTERFACE SECURITY SYS LLC
Address: 3750 SCHAUFELE AVE #200
LONG BEACH CA 90808
Phone: 562-3534440
Code Edit: 2019
Type of Construction: V -B -SPR
Occupancy Group: M
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 0
Flood Zone:
Bldg Sprinklers: Y
Construction Valuation: $2,735.00
Building PC Fee :
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Fee:
Fire Plan Check Fee:
Fire Permit Fee :
Building Permit Fee
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PROCESSED BY:
ZONING APPROVAL: �
FIRE APPROVAL:
Legal Description:
P BK 221 PG 30 PAR 6
Contractor:
INTERFACE SECURITY SYS LLC
Address:
3773 CORPORATE CENTER DR
$0.00
EARTH CITY, MO 63045
Phone:
314-565-0100
Con State Lie:
469046
Lie Expire:
0813112923y0 -k -A
Bus Lie:
BT30046473
Lie Exp Date:
031311 M02 'L07.a._
Worker's Compensation Insurance
Carrier:
TRAVELERS PROPERTY
Policy No:
UB9K06344620
Expire:
10/01/2021
Issued Date: 0411412021
Setback- Front:
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Rear:
Left:
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Right:
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FEES
$0.00
Fire Residential Alarm PC Fee:
$0.00
Planning Counter Review:
$0.00
Planning Zoning PC Fee:
$0.00
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$166.75
Public Works PC Fee
$237.75
Public Works Traffic Plan Check Fee;
$0.00
$416.50 Plan Check Fee:
Architect: � 1
Address: � '@,� IS -11—p�
Phone: State Lic: ii
Engineer
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
State Lie:
PETTY PAUL
3750 SCHAUFELE AVE #200
LONG BEACH CA 90808
$0.00 Records Management
$0.00
$0.00
$0.00
$0.00
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$12.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $416.50
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 L) 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
Erim roved for the purpose of sale).
1, 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 legally
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 Codei is available upon request when this application is submitted or at the following Web site:http:/ANww.leginfo.ca.gov/calaw.htmi.
Signature of Properly Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
1412tdb affirm A?Jlr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busine s and Pr ssions Code, and my license is in full force
and effect.
L'aensa Class . License No D�tp� r - `� ' Z I Contractor ature e
VYOR,KERS' qPffl€NSATION DECLARATION ✓�
NARNINO: 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 ($100,000), IN ADDITION TO THE
Cost QF COMPEIJV119N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I trdfa% affirm ungdrjWnally of perjury one of the following declarations:
MI have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thI
�$orhjance of fl a work for which this permit is issued. Policy No.
and wllZilltain 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' compensatior
os ranee carrier•and policy number are:
errier • • • • • • Policy Number Expiration Date
is of Agent i none r
certify that, in the performan gg(( the work f which this permit is issued, I shall not employ any person in any manner so as to become su
if I shovkLbecome subjpc o,tfle yaorJcBrp compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
ender's Name Lender's Address
ly 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 count 0d ina ved state laws relating to building construction.
I authorize representatives of this city oVeu e r a -identified property for inspection purposes.
nature of Property Owner or Aut
Agent 7`/l
Print Property Owner's or Authorized ey*s Nr
ACTION
DATE BY
DECLARATION OF COMPLIANCE IM IHCOO
FEDERAL REGULATIONSPART 69 OFTITLE40 ANO
AQMD RULE 9403.
PERMtTEXPIRED
❑ISUBN6TTEOASBESTOSNOBFiCATIONTO.
❑ EPA
❑ AQMD
PERMITC,ANCELLED
PERMiTEXTENDED
EMOLITION.RONIS NOT .4FF1lCA8L€TO
P❑ROPOSEDASBESTOS
PERMIT FINAL ia—( t—�,Q a
CERTIFICATEOF
OCCUPANCYISSUED
SIGNATURE:
the workers' compensation laws of California, and
-iv-z
(Section 3097, Civil Code).
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