HomeMy WebLinkAboutF2018-0325 - Permits (2)w, City of Newport Beach - Building Division *F2018-0325* FIRE Permit: F2018-0325
100 Civic Center Drive, Newport Beach, CA 92660 Project No: 1308-2018
Permit Counter Phone (949)644-3288
ny xw` Inspection Requests Phone (949)644-3255
Job Address: 409 N BAY FRONT NB Description: SFR FIRE SPRINKLERS 36 HEADS (X2017-1348)
Inspector Area: 2
Owner: GUNDERSON DAVE
Address: 409 N. BAY FRINT
NEWPORT BEACH, CA
Phone
Applicant: KELLY SEAN
Address: 10141 THESUS DR
HUNTINGTON BEACH, CA 92646
Phone: 714-907-7586
Code Edit: 2016
BALBOA ISLAND REBUS SEC 1 BLK 8 LOT 5
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:
Building Overtime PC Fee:
Bldg Sprinklers:
N
Legal Description:
BALBOA ISLAND REBUS SEC 1 BLK 8 LOT 5
Contractor:
KELLY FIRE PROT INC
Address:
10141 THESEUS DR
$3,800.00
HUNTINGTON BCH CA 92646
Phone:
.714-907-7586
Con State Lic: 878823
Lic Expire: 0813112019
Bus Lic: BT30042225
Lic Exp Date: 01/31/2019
Worker's Compensation Insurance
Carrier: AMERICAN FAM HOM INS
Policy No: 2EA5WC000024601
Expire: 0 4/1 112 01 9
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Issued Date: 06/04/2018 Special Conditions:
Setback- Front:
Rear:
Left:
Right:
State Lic:
• ••
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eo
State Lic:
000
KELLY SEAN
10141 THESUS DR
HUNTINGTON BEACH, CA 9264i... •�
714-907-7586
00 m
eo 0
e00000
6 0 0
0 0
000000
0
0000
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL:] PLAN CHECKED BY::
FIRE APPROVAL: r V' APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$3,800.00
_
Building PC Fee :
$190.00
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 :
$225.00
TOTAL FEE :
$417.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$417.00
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL:] PLAN CHECKED BY::
FIRE APPROVAL: r V' APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
VNER-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)
action 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
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
Ifessions 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
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,
siness 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
movements 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
moved 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
fly to an ownejptproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exemptlroa►Ilcensure under the Contractors' State License Law for the following reason:
pW.EIgnature belpV 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
sbucture 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
Ifae�ions Code, Is available upon request when this application is submitted or at the following Web site:hftp:/Iwww.leginfo.ca.gov/calaw.htmi.
%1,p'e of Propell'ty Owner or Authorized Agent Date
:EUSED CV TPRQCTOR'S DECLARATION
qaffirm LIMIsT penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and P fessions Code, and R Y license is in full force
to ect. •°%
€14.Class License No Date Contractor Signature • r���1
5AR RS' COMPENSATION DECLARATION
• ° • 000 IN ADDITION TO THE
iJING• AILUR i� O SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPL ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO R31 100, I,
rT OFCOMPENSRITZJAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
,Teb9•°affirm unde; Qenalty of perjury one of the following declarations:
i neve and will wmintain 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
fprmance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
Date
ie of Agent - i none s
certify that, in the perfopMance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subjectthe workers' compensation laws of California, and
, if I should become sy6ject tolthe workers' corppensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro/s ions.
nature of Applicant ti's`- vare�
CLARATION REG DING CONSTRUCTION LEPM AGENCY
ereby affirm under penalty of perjury that there is truction lending agency for the performance of the work for which this permit is issued (Section 3097
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 owner's behalf.
I have read this application and the informatio I have provided is correct.
I agree to comply with all applicable city and ounty ordinances and state laws relating to building construction.
I authorize representatives of this city or cou ty to of ter the abPve-identified property for inspection purposes.
nature of PrODertv Owner or Authorized Aoe /�.i )4e-, _. Print Property Owner's or Authorized Agent's Name 5 "�
ACTION I DATE I I BY
PERMITEXPIRED I I ----A I I
PERMITCANCEILED I I V / I
PERMIT FINAL
CERTIFICAT€OF
OCCUPANCYISSUED
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PROPOSED DEMOLITION.
SIGNATURE:
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