HomeMy WebLinkAboutF2019-0231 - PermitsW1 City of Newport Beach - Building Division IIIIIIIIIIIIIIII'IIIIII�IIIIIIIIIIIIIIIIII
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FIRE Permit: F2019-0231
100 Civic Center Drive Newport Beach, CA 92660
Construction Valuation:
F 2 0 1 9 0 2 3
1
Project No: 0863-2019
Building PC Fee :
x
Permit Counter Phone (949)644-3288
$0.00 Records Management:
$2.00
Building Overtime PC Fee`.
$0.00
- Planning Counter Review:
$0.00
Building Extention Fee :
$0.00
Inspection Requests Phone (949)644-3255
$0.00
Building Investigation Fee.:
$0.00
-
Job Address: 3300 NEWPORT BLVD NB
$0.00
Description: COMM FIRE ALARM ADD (1) DEVICE "LIDO HOUSE ROOFTOP BAR" _
$189.00
Inspector Area: FIRE
Legal Description:
1117 LOT 3 POR OF LOT AND LANCASTERS ADD AND FOR THE HUDSON
Fire Permit Fee :
Owner: RD OLSON DEVELOPMENT
Contractor:
WEST COAST FIRE & INTEGRATIONS
Architect:.
Building Permit Fee:
--:
Address: 520 NEWPORT BLVD
Address:
3199-D AIRLOOP DR
Address:
$414.00
Plan Check Fee:
NEWPORT BEACH, CA 92663
$414.00
COSTA MESA CA 92626
Phone:
- Phone:
562.665-0883 -
Phone:.
State Lia:
Applicant: COLLIEENIWEST COAST FIRE
Con State Lia
989173
Engineer.
_I
Address: 3199D AIRPORT LOOP OR `
Lie Expire:
X 1213112019
Address:
COSTA MESA CA 92626
Bus Lia
BT30060007
y
!
Phone:. 714.957.5750
Lie Exp Date:
02/28/2020-.
Phone:
State Lie:
Code Edit : 2016
Worker's Compensation Insurance
Designer:
ACHERMECK DANIEL
Type of Construction: 1AIVAIVBSPK
Carrier:
AFH INS. CO,
Address:.
. 3199-D AIRPORT LOOP DR
- Occupancy Group: AIB/R
Policy No:
2EA5WC900066500-.
`COSTA MESA CA 92626
Added /New sq.ft.. Bldg; 0
Expire:
01/15/2020
Phone:
714-957-5750
Added /New sq. ft. Garage: 0
No of Stories: 4
Issued Date: 04116/2019
Special Conditions:
LIQUEFACTION AREA
No of Units: 0
Setback- Front:
Flood Zone: - X
Rear.
-
Bldg Sprinklers: Y
Left:
Right:
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
o�n ogm .0.---@THER-DEPARTMENT:
%LAN 1*iE0fj2D BY:: -
-APPROVAL TO ISSUE:
O
PERMIT EXPIRES 180 DAYS„4FTPR /SPAW-40 2LASS 14,A' LID INSPECTION
FEES
Construction Valuation:
$1,160.00'
Building PC Fee :
$0.00
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:
$189.00
Public Works PC Fee :
$0.00
.$0.00
Fire Permit Fee :
$223.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTALFEE :
$414.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance `
$414.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
o�n ogm .0.---@THER-DEPARTMENT:
%LAN 1*iE0fj2D BY:: -
-APPROVAL TO ISSUE:
O
PERMIT EXPIRES 180 DAYS„4FTPR /SPAW-40 2LASS 14,A' LID 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 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improvesthe 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). -
❑ 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 residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal)
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 Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. p _ ,
License Class License No Date 0 L{ (� t Q Contractor Sign afy �_ �lic�e'
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 6706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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 lhE
performance of the work for which this permit is issued. Policy No.
Ahave and will mai in 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
isurance carrier and p id umber are:
:arder u er Expiration Date
lame of Agent q Ir ,a Phone #
]I certify that, in the 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 agre
iat, if I should become slibilct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant I/11/Z1'nN-'_'•/ALL/ _ Da 001 u(lef
IECLARATION FErARqING CWNSTRUCTION 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
sy'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 and state laws relating to building construction_
I authorize representatives of this city or cou y t en r th bove--' entifi d property for inspection purposes. 0� 1c�/lp
'�i nature of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's 211 el L to
ACTION DATE BY DECLARATION OF COMPUANCEWITN CODEOF _ FOR OFFICE OSEONLY.
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