HomeMy WebLinkAboutF2018-0337 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 416 MARGUERITE AVE NB
Inspector Area: 5
Owner: HIS 300 PARTNERS LLC
Address: 20201 SW BIRCH ST #100
NEWPORT BEACH CA 92660
Phone:
Applicant: TERRIIFIRE SPRINKLERS SYS
Address: 705 E HARRISON #200
CORONA CA 92879
Phone: 951-272-2522
FIRE SPRINKLER SYSTEMS INC
Code Edit: 2016
705 E HARRISON #200
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:
3
No of Units:
0
Flood Zone:
X
Bldg Sprinklers:
Y
*F2018-0337* FIRE Permit: F2018-0337
Project No: 2163-2017
Inspection Requests Phone (949)644-3255
Description: MFR FIRE SPRINKLERS 9 HEADS *ADDITIONAL SCOPE*
Legal Description: CORONA DEL MAR BILK 439 LOT 10
Contractor:
FIRE SPRINKLER SYSTEMS INC
Address:
705 E HARRISON #200
Construction Valuation:
CORONA CA 92879
Phone:
800-915-3473
Con State Lie:
684600
Lie Expire:
02129/2020
Bus Lie:
BT30027990
Lie Exp Date:
0 512 012 01 9
Worker's Compensation Insurance
Carrier:
INS CO OF THE WEST
Policy No:
WSD5031314
Expire:
10101/2018
Issued Date: 06/0812018
Setback- Front:
Rear:
Left:
Right:
Architect:
FEES
Address:
Construction Valuation:
$3,550.00
Phone:
State ifiG'r
$190.00
Fire Residential Alarm PC Fee:
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$0.00
Engineer:
$0.00
Planning Counter Review:
Address:
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Phone:
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$0.00
Building Investigation Fee:
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Designer:
BISHIP JAMIE '
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Address:
705 E HARRISON ST # 200
Public Works PC Fee:
$0.00
CORONA CA 92879 • ee
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Phone:
951.272-2522
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Special Conditions:
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TOTAL FEE :
$415.00
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$0.00 Fee Due at Permit Issuance :
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PROCESSED BY: / OTHER DEPARTMENT:
ZONING APPROVAL: -, PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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: / OTHER DEPARTMENT:
ZONING APPROVAL: -, PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 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 items)
(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 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, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of PropgrW.Qwner or Authorized Agent Date
LICENSED CCINJUrTOR'S DECLARATION
I D@reD% Ifhrm unq%rpgnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ection 7000) of Division 3 of the Business and Pr salons Co nd my license is in full force
and effeot.
LicenserClass • • License No Date Contractor Signature
WORMERS' COMPENSATION DECLARATION
•...
WARNING, FAILUREQO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5700,000), IN ADDITION TO THE
CDS1PgF.0bMPENSA11eIf,, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I D%T: vaffirm ugdelpenalty of perjury one of the following declarations:
12.I.baue and win 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 thl
p• prVWpce of the IV for which this permit is issued. Policy No.
1 h sand will:niOmtein 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
nsuiens® carrier and policy number are:
Cagier. • . •. * * • Policy Number Expiration Date
is of Agent rnone i
certify that, in the perfor ance of the work fo h this permit is issued, I shall not employ any person in any manner so as to become su
if I should become sulflect to the wo compensation proviso of Section 3700 of the Labor Code, I shall forthwith comply with those
nature of Applicant
CLARATION REGAR INGIONLENDING AGENCY
;reby affirm under perfalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
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 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 county to after the at Wtified propertypection purposes.
nature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's
ACRON DATE BY DECLARATION OF COMP ANCEWITNCODEOF
FEDERAL REGULATIONS PART Of OF TITLE40AND
P€RMITEXPIRED AOMD.RULE 1403.
❑ I SUBMtTTEDASBESTOS NO7IFICATION TO:
PERMITCANCELLED - ❑ EPA
P€RMITEXTENDED ❑ AOMD
PERMIT FINAt i° POSED DEMOLITION. ASBESTOS TIONIS NOT APPLICABLE TO
CERTIFICATEOF
OCCUPANCYISSUED SIGNATURE:
the workers' compensation laws of California, and
(Section 3097, Civil Code).
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