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HomeMy WebLinkAboutF2019-0133 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive; Newport Beach, CA 92660. F 2 0 1 9 0 1 3 3 Permit Counter Phone (949)644-3288 Job Address: 314 DAHLIA PL NB Inspector Area 5 owner: NSC ENTERPRISES Address:. P.O. BOX 982 CORONA. DEL MAR, CA 92625 Phone:. Applicant: FIREPROOF FIRE PROTECTION Address: 1101 KINGSTON DR LA HABRA CA 90631 .:Phone: 714-476-5370 Code Edit: 2016 Type of Construction: V -B -SPR Occupancy Group:. R3/1.1 Added /New sq.ft. Bldg:.. 0 Added /New sq.. ft. Garage: 0 No of Stories:. 3 No of Units : 0 Flood Zone: Bldg Sprinklers:. N 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 11 TOTAL FEE : PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL $3,000.00 FIRE Permit: F2019-0133 Project No: 2086-2017 Inspection Requests Phone (949)644-3255 Description: MFR FIRE SPRINKLERS 25 HEADS (X2015-1751) Legal Description: Contractor: OWNERIBLDR Architect: Address: KAVIANI SHEILA : Address: Phone: Con State Lic:. O/B Lic Expire: Bus Lic:.. Lic Exp Date: Worker's Compensation Insurance Carrier:.. Policy No: Expire: Issued Date: 03/1312019 Setback- Front: Rear: Left: Right: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: FEES Fire Residential Alarm PC Fee: $0.00 Planning Counter Review: $0.00 Planning Zoning PC Fee : $0.00 Public Works PC Fee: $0.00 Public Works Traffic Plan Check Fee; $0.00 Plan Check Fee: State Lic; State Lic CASEY MONTY 1101 KINGSTON DR LA HABRA, CA 90631 714476-5370 Records Management $0.00 Fee Due at Permit Issuance : OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION tri Dome : 0 0 mmmm m e m 0000eo o m m o 00 om m s o m om c omoomm m o 0 o m o om o o m 0 o c oa000 0o mo 0 omm'oo 0 0 o c o 0 000mom o m om om o o e o oem'e 000e $0.00 $0.00 $0.00 $35.00 OWNER -BUILDER DECLARATION 1 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 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). I 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 residenc;3,,in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) sell a structure that I have built as an owner -builder if it has not be on cted' it ety 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 app' su tied he following Web site:http://www.leginfo.ca.gov/ca[aw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION/ I 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 and Professions Code, and my license is in full force and effect. .... License Class ' ' License No Date Contractor Signature $RKERS' COMPENSATION DECLARATION ;NING.FAILUR6- swURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE I OP COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. re" affirm under penalty of perjury one of the following declarations: 1 have and wfi'maartain 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 bHance of (he work for which this permit is issued. Policy No. hava and vi0maintain 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' compensatioi Trance carrier and policy number are: Policy Number Agent Date eolty that, eft performance 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Date 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 issued (Section 3097, Civil Code). Ender's Name Lender's Address ymy 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or county to Pen /. _ - Te y for inspection purposes. /�/' ,,/ ianature of PrODertv Owner or Authorized Agent �c l // �r „ Print Property Owner's or Authorized Agent's Name ACT70N I DATE I BY PERMITEXPIRED ❑ I SUBMfTTEDASBESTOS NOTIFICATION TO: PERMITCANCELLED ❑ EPA PERMIT EXT€NDED _ ❑ AQMD ❑ ASBESTOS M017RCARONIS NOT APPLICABLE TO PERMIT FINAL PROPOSED DEMOLITION. CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: a m I mm m N u W V Q) ?I T T m � a CL H 0 m 0 3 CL OC a K C N N CL OD N M. 3 a CL M. d S Q N N A ❑❑❑❑ ❑❑❑❑❑❑❑❑❑1® t0 z§ 2© / 2000 22 0 E22 0 00 # ]( \m a� ] ) \ ( § k § B }/ k ! �\ { E () { \ � 7 7kt f)t _ -\�k� _ ! «k§/ /)&Ea \\�\ \\ � «%k{$ t» []\ ca �fa,E ]§}E ak }\)0 w \\\\ k\/ # ]( \m a� ] ) \ ( § k § B }/ ! �\ { E () { \ C 7kt f)t & co -\�k� _ ! «k§/ /)&Ea � «%k{$ t» []\ ca �fa,E # ]( \m a� ] ) \ ( § k § B