HomeMy WebLinkAboutF2017-0514 - PermitsCity of Newport Beach - Building Division IIIII�IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIII II FIRE Permit: F2017-0514
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 7 0 5 1 4
Project No :2163-2017
P s Permit Counter Phone (949)644-3288
'r�.txrra�a Inspection Requests Phone (949)644-3255 _...__
Job Address: 416 MARGUERITE AVE NB
Description: MFR FIRE SPRINKLERS ($6) HEADS (X2016-4298)
Construction Valuation:
$3,550.00
Building PC Fee:
$190.00
Inspector Area: 5
Legal Description:
CORONA DEL MAR BLK 439 LOT 10!]
$0.00
Planning Counter Review: $0.00
Owner: HB 300 PARTNERS LLC
Contractor:
FIRE SPRINKLER SYSTEMS INC
Architect:
Building Investigation Fee:
$0.00
Address: 20201 SW BIRCH ST #100
Address:
705 E HARRISON #200
Address:
Public Works PC Fee : $0.00
$0.00
NEWPORT BEACH CA 92660
$0.00
CORONA CA 92879
Building Permit Fee :
$225.00
Phone:
Phone:
800-915-3473
Phone:
State Lie:
$415.00
PROCESSED BY:
ono A aa," OTHER DEPARTMENT:
ZONING APPROVAL:
Applicant: TERRI/FIRE SPRINKLERS SYS
Con State Lie:
684600
Engineer:
APPROVAL TO ISSUE:
Address: 705 E HARRISON #200
Lie Expire:
0212812018
Address:
o • c
CORONA CA 92879
Bus Lie:
BT30027990
Phone: 951-272-2522
Lie Exp Date:
05/20/2018
Phone:
State Lie:
Code Edit: 2016
Worker's Compensation Insurance
Designer:
BISHIP JAMIE
Type of Construction: V-BSPR
Carrier:
INS CO OF THE WEST
Address:
705 E HARRISON ST # 200
Occupancy Group: R31U
Policy No:
WSD6031314
CORONA CA 92879
Added /New sq.ft. Bldg: 0
Expire:
10101/2017
Phone:
951-272-2522
Added /New sq. ft. Garage: 0
No of Stories: 3
Issued Date: 09/2712017
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
Right:
FEES
Construction Valuation:
$3,550.00
Building PC Fee:
$190.00
Fire Residential Alarm PC Fee : $0.00 Records Management:
$0.00
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 :
$225.00
TOTAL FEE :
$415.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance :
$415.00
PROCESSED BY:
ono A aa," OTHER DEPARTMENT:
ZONING APPROVAL:
S 4
PLAN CHECKED BY::
FIRE APPROVAL:
APPROVAL TO ISSUE:
PERMIT �XPIRjS 180 D;Y.� AFTER,'IS�UANCE OR LAST VALID INSPECTION
o
`
o • c
LDER 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).
1, 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://www.leginfo.ca.gov/calaw.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 Secti 7000 f Division 3 of the Business and Professions Code and I ense is in ful force
and effect. d qp
License Class License No Dat -/ 0C� Contractor Signatur
INORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN DOLLARS ($100,000), IN ADDITION TO THE
COST 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:
1 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 the
)dfformance of the work for which this permit is issued. Policy No.
have and wiIntain 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'
rance carrier a d olicy number are;,
certify that, in the performanc94the work for which this permit is issued, I
if I should become sub' t 6th orkers' compedo isions of Sec
nature of Applicant
Date
any person in any manner so as to become subject to the workers'
Labor Code, I shall forthwith comply with those pi;9visions. / ,
hereby affirm under penalty of perjury that thkjo0irs a construction lending agency foo the performance of the work for which this permit is issued (Section 3097, Civil Code)
Ender's Name Lender's Address
Iy my 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 andt>a ate lawwlating toJpe
ldin construction.
I authorize representatives of this city or coun/ ter above -id Ied� operty f
If
purposes.
linnature of Prnnerty Owner nr Authorized ADent crti%i.�.i Uwih t Prooertv Owner's or Authorized Agent's Name
laws of California, and
Date
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