HomeMy WebLinkAboutF2020-0319 - Permitsw City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
FatswrA�`s
Job Address: 4621 ORRINGTON RD NB
Inspector Area: 5
Owner: WELLING GLEN & LAURI
Address: 4621 ORRINGTON RD
CORONA DEL MAR, CA 92625
Phone:
Applicant: CASEY MONTY
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone: 714-476-5370
Code Edit: 2019
Type of Construction:
VB
Occupancy Group:
R31U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
0
Flood Zone:
Bldg Sprinklers:
Y
Construction Valuation
Building PC Fee
Building Overtime PC Fee:
Building Extention Fee:
Building Investigation Fee
Fire Plan Check Fee:
Fire Permit Fee :
Building Permit Fee:
TOTALFEE
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
$6,600.00
III�F 2 0 20 0 1 9�9II
FIRE Permit: F2020-0319
Project No: 1365-2020
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLER (73) HEADS (X2019-2820)
'REVISED 0313112021
Legal Description: N TR 3357 LOT 67
Contractor:
FIREPROOF FIRE PROTECTION
Address:
1101 KINGSTON DR
LA HABRA CA 90631
Phone:
714-476-5370
Con State Lie:
876004
Lie Expire:
04/30/2022
Bus Lie:
BT30040107
Lie Exp Date:
08/31/2021
Worker's Compensation Insurance
Carrier:
SECURITY NATIONAL INS
Policy No;
SWC1325710
Expire:
02/15/2022
Issued Date: 09/03/2020
Setback- Front:
Rear:
Left:
Right:
FEES
Architect:a
Address:
L
Phone:
State Lie:
Engineer:
Address:
EE@ U
Phone:
State Lie:
C?,
Designer:
CASEY MONTY -
(-)
Address:
1101 KINGSTON DR
LA HABRA CA 90631=
Phone:
Special Conditions:
$202.00
Fire Residential Alarm PC Fee:
$0.00 Records Management
$0.00
Planning Counter Review :
- $0.00
$0.00
Planning Zoning PC Fee:
$0.00
$0.00
$0.00
Public Works PC Fee :
$0.00
$0.00
Public Works Traffic Plan Check Fee;
$0.00
$240.00
$448.00
Plan Check Fee:
$448.00 Fee Due at Permit Issuance
OTHER DEPARTMENT:
a °
P •PLAt16HECKED E°Y:j
aRPROVAL-114-1ISSUIE:
3P m
m
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR,LAST.VALidiNSPECTION
$6.00
$0.00
$0.00
$0.00
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
m 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
of more than five hundred dollars ($500).
11, as owner of the property, or my employees With wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
usiness 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
nprovements 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
nproved for the purpose of sale).
1 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
pply 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:
ly 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
Tofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.m.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 andPfessions Code, and my license is in full force
nd effect. �—
icense Class License No Date 3 It l Contractor Signature
PORKERS' COMPENSATION DECLARATION
TANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST 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:
I pave 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 thr
erfy6ance of the work for which this permit is issued. Policy No.
have and will ' Intain workers'
rance carrier aril plicv numbef.
IS, of Agent -
certify that, in the pi
, if I should become
lature of Applicant _
as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
Expiration Date
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
the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov' ons.
%-.__ _ nor ] ) )l /n-I
Ueby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued
Iders 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 owners 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 coun to rite the above -identified property for inspection purposes.
nature of Property Owner or Authorized Agent l t Print Property Owners or Authorized Agent's.Narr
3097, Civil Code).
11
ACTION
DATE
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