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Home My WebLink AboutF2020-0492 - Permitstix�PrrE, City of Newport Beach - Building Division II�IIII IIIIIIIIIII III�IIIIIII IIIIII II 04 �r 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �r D '�ttYillr Job Address: 2601 BLACKTHORN ST NB Inspector Area: 4 Owner: WARNER CHRISTIAN Address: 2601 BLACKTHORN ST NEWPORT BEACH, CA 92660 Phone: Applicant: KELLY SEAN Address: 10141 THESUS DR HUNTINGTON BEACH, CA 92646 Phone: 714-907-7586 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: 2 No of Units : 0 Flood Zone: Bldg Sprinklers: N FIRE Permit: F2020-0492 Project No 2277-2020 Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLER SYSTEM 43 HEADS (X2020-1259) Legal Description: N TR 4893 LOT 90 Contractor. KELLY FIRE PROT INC Architect {g�� 0 M� S �r U l Address: 10141 THESEUS DR Address: HUNTINGTON BCH CA 92646 Phone: 714-907-7586 Phone: State Lic: Con State Lie: 878823 Engineer: Lie Expire: 0813112021 Address: Bus Lie: BT30070761 - Lie Exp Date: 01/3112021 Phone: State Lie: Worker's Compensation Insurance Designer: KELLY SEAN Carrier: AMERICAN FAN HOM INS Address: 10141 THESUS DR Policy No: 2EA5WC000024603 HUNTINGTON BEACH, CA 92646 Expire: 0411112021 Phone: 714-907-7586 Issued Date: 12/09/2020 Special Conditions: Setback- Front: Rear: Left: Right: FEES Construction Valuation: $3,400.00 Building PC Fee : $217.00 Fire Residential Alarm PC Fee : $0.00 Records Management : $2.00 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 : $263.00 TOTAL FEE : $482.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $482.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: �T PERMIT EXPIRES 190 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 rile 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 U all of or U 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 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 Code, L 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 affina under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing th action 7000) of Division 3 of the Business a rofessions Code, nd my license is in full force and effect. �3_�i�1 Ucenbe Class License No Date Contractor Signature WORKERS' COMFENSATION DECLARATION W..RNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE O CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND S (E100,000), 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 fallowing declarations: CJ 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 th per'forr.ance of the wo-k for which this permit is issued. Policy No. 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' Niue carrier and policy number are: "ter Policy Number Expi ie of Agent Phor certify that, in the p rformance of the work for which this permit is issued, I shall not employ any person in any manner s0 as to become if I should Dec a subject to thheeeAorkers' compepp��ation provisi ns of Section 3700 of the Labor Code, I shall forthwith comply with the iature of Applic n _ l �y� / D; hereby affirm under denalty of perjury that there is akonstflfction lending agency for the performance of the work for which this permit is issued ( ender's Name ,,VV 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 owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and cou' ordinances and sitate laws relating to building construction. I authorize representatives of this city or county to nter he abovlf,)dentified property for inspection purposes. ionature of ProDertv Owner or Authorized ADent 6A" Print Property Owner's or Authorized Agent's Name Date to the workers' compensation laws of California, and Z, iC,7 3097, Civil Code). ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1403. PERMITEXPIRED P ❑/SUBMITTEDASBESTOSNORFICATIONTO: ❑ EPA ❑ AQMD ASBESTOS PROPOSED DEMOLITION.RON IS NOT APPLICABLE TO PERMITCANCELLED PERMITEXTENDED PERMIT FINAL �— CERTIFICATEOF SIGNATURE: OCCUPANCYISSU€O