HomeMy WebLinkAboutf2020-0233 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
w. Permit Counter Phone (949)644-3288
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Job Address: 512 BEGONIA AVE NB
Inspector Area: 5
Owner:
MULFUR CYNTHIA & TOM
Address:
76191 VIA UZZANO
INDIAN WELLS CA 92210
Phone:
503-333-4590
Applicant:
SIRIGNANO KEITH
Address:
22672 LAMBERT ST #619
LAKE FOREST CA 92630
Phone:
949-521-2460
Code Edit: 2019
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
3
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
II�IFIIIII0IIIII0llllll3llY III
FIRE Permit: F2020-0233
Project No: 0923-2020
Inspection Requests Phone (949)644-3255
Description: MFR FIRE SPRINKLERS (45 HEADS) X2019-1844
Legal Description: CORONA DEL MAR BILK 530 LOT 14
Contractor: ALL STAR PLUMBING & FIRE SPRINKLER COMPANY Architect: �,
Address: LAKE FOREST CA 92609 1413 Address: I pr j r �
Phone: 949-470-0072 Phone: State LiLjEj
c:
Con State Lic: 715588 Engineer:
Lic Expire: 08131/2021 Address:
Bus Lic: BT30059737
Lic Exp Date: 0713112021 Phone: State Lic:
Worker's Compensation InsuranceNc9 Ad'� N p RUCT1 i IGNANO KEITH
Carrier: BENCHMARK INS '�d9tle p LAMBERT ST#619
Policy No: CST5018455 LAKE FOREST CA 92630
Expire: 0210512021 Phone: 949-521-2460
Issued Date: 1111712020
Setback- Front:
Rear:
Left:
Right:
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FEES
Construction Valuation:
$6,000.00
Building PC Fee:
$202.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
$6.00
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
$0.00
Fire Plan Check Fee:
$0.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee:
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$240.00
TOTAL FEE :
$448.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$448.00
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY:: N _
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
)WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checkmark(s) 1 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 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 Iicensure 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 1 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.•••pe..nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section .7000) of Division 3 of the Business and Prof o ode, and my license is in u force
�•P,tort. • • p
License Class • • • • • • License No �lCe I '7 %2� Contractor Si re
VYQ,RKERS' COIIQPENSATION DECLARATION I�
Y9ARNIN6: FAILURE TO SECIARE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,0001, IN ADDITION TO THE
COST OGCOMPENSATI W"MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I $efty affirm under penalty of perjury one of the following declarations:
..•
at -have and tijl•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 the
pecfar•mance of the work for which this permit is issued. Policy No.
$AaSPrand will•maiptain 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
I rance cardeF jr1&pd1icy number are:
C7}t�r_•y _ Policy Number Expiration Date
NaYrfl?•df Agent
certify that, in the performance of the
, if I should become subject to thgAM
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
mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1
Signature of Ap nt f 1 "�
DECLARATION R ARDIN ION LENDING AGENCY
I hereby affirm under penalty at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
1 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 ordinance nd s e laws relating to building construction.
I authorize representatives of this city or county to enlqV-Iov tified property for inspection purposes. IL A 7
iature of Property OM
AC77ON
PERMITO(PIRED
PERMf7 CANCELLED
PERMfTEh7ENDE0
PERMIT FINAL
CERT7FICATEOF
OCCUPANCYISSUED
Owner's or
FEDERAL R€GULATIONSPART 61 OF T17L€40 AND
AQMD RULE 1403.
❑ ISUDM[ITEDASBESTOS NQAFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS N07IFICA710MISNOT APPLICABLE TO