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HomeMy WebLinkAboutF2018-0027 - Permitslam$ City of Newport Beach - Building Division 11llllllllllllllllllllllllllllllllllllllllllllllllil jl ". 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 8 0 0 2 7 Permit Counter Phone (949)644-3288 Job Address: 1850 JAMBOREE RD NB Inspector Area: FIRE Owner: BIG CANYON COUNTRY CLUB Address: 1 BIG CANYON Address: 3600 BIRCH ST 3220 NEWPORT BEACH, CA 92660 Phone: 0 813 112 01 9 FIRE Permit: F2018-0027 Project No: 0096-2018 Inspection Requests Phone Description: COMM RELOCATION OF EXISTING FUEL TANK (ABOVE GROUND 't<oAUll4 - -3c(-I D Legal Description: IRVINE SUB LOT BLK 92 POR OF BLK AND POR OF BLK 93 Contractor: SLATER BUILDERS INC Architect: Address: 3100 - B PULLMAN STREET Address: COSTA MESA CA 92626 Phone: 714.615.6108 Applicant: COLLINS TIMOTHY Con State Lie: 675832 Address: 3600 BIRCH ST 3220 Lie Expire: 0 813 112 01 9 NEWPORT BEACH CA 92660 Bus Lie: BT30026319 Phone: 949-863-9099 Lie Exp Date: 02128/2018 Code Edit: 2016 Worker's Compensation Insurance Type of Construction: Carrier: STATE FUND Occupancy Group: U Policy No: 9044505 Added /New sq.ft. Bldg: 0 Expire: 0211612018 Added /New sq. ft. Garage: 0 No of Stories: 0 Issued Date: 0112212018 No of Units : 0 Setback- Front: Flood Zone: Rear: Bldg Sprinklers: N Left: Right: FEES Construction Valuation: $18,000.00 Building PC Fee: $0.00 Fire Residential Alarm PC Fee: Building Overtime PC Fee: $0.00 Planning Counter Review: Building Extention Fee: $0.00 Planning Zoning PC Fee: Building Investigation Fee: $0.00 Fire Plan Check Fee: $355.00 Public Works PC Fee Fire Permit Fee : $362.00 Public Works Traffic Plan Check Fee; Building Permit Fee : $0.00 TOTALFEE: PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL : Plan Check Fee: Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: COATSWORTH CALVIN J 2495 CAMPUS DR, 2ND FLR IRVINE CA 92612 949-833-1930 State Lie: C014388 eeoo e e e•ee e o mmmmme State Lie: e •e e V. e em om © m e 00 o n • ooc0 <o m c o Duo 0 $0.00 Records Management: $6.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $723.00 Fee Due at Permit Issuance : $0.00 OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION o c o e o 00 0 mo•oo m Omm JO 000000 e o c o mee•ao 0 0 om•o 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 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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or im roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://w ,leginfo.ca.gov/calaw.htmi. Signature of PropdrVOIyner or Authorized Agent Date LJCEN$ED CONTRACTOR'S DECLARATION E d I jlfbft b9 dffirm upV2r p. alty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000) {Division 3 of the Business and Professions Code, d my license is in full force anal effect. License Class License No Date q Contractor Signature kRKERS' COMPENSATION DECLARATION d WARNING+FAILURE T,D.SECWRE 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 150 COMPENSAJION..D. MAGES AS PROVIDED FOR IN SECTION OTOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 4n2fdbypffirm uhVl r-peplty of perjury one of the following declarations: ❑ ••• I have and wilLmaintain 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 thl V"ormI ce of ft.wortfor which this permit is issued. PolicyNo.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' compensatior carrierand policy number are: tamer • �.. Policy Number Expiration Date of Agent certify that, in the performance of the work f which this a It is issued, I shall not employ any person in any manner so as to become subject to the , if 1 should become subject to the workk2rrcompensati rovi 'ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. latureofApplicant X O"r Date 3reby affirm under penalty of perjury that there is a construcJfon lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider's 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 pr perty owner's behalf. I have read this application and the information 1 have provided 1 correct. I agree to comply with all applicable city and county ordinance and state law lating to building construction. I authorize representatives of this city or county to nter th ve-identifie y for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Aent's NI ACTION DATE BY ECLARATION OF COMPLIANCEWITR CODEOF IFEDERAL REGULATIONS PART 61' OF 711LE40AND AOMD RULE 1403. P£RMITEXPIR€D ❑ 1 SUBMfTTEDASSESTOS NOTIFICATION TO: ❑ EPA ❑ AOMD PERMITCA.NCELLED PERMITEXTENDD 0 ASBESTOS PROPOSED DEMOLITION.DONtS NDT APPLtCAt3LE TO PERM1TRAIAL '-�'j�( CERTIFtCATEOF OCCOPANCYISSUED SIGNATURE laws of California, and 0'VAI Date