HomeMy WebLinkAboutF2019-0070 - Permits1r, City of Newport Beach -
Building Division
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FIRE Permit: F2019-0070
Type of Construction:
V-BSPR
Carrier: NORGUARD INS CO
Address:
1101 KINGSTON DR
Occupancy Group:
R31U
Policy No: MOWC901180
$0.00 Records Management:
LA HABRA CA 90631
Added /New sq.ft. Bldg:
0
Expire: 02/15/2019
Phone:
Added /New sq. ft. Garage:
0
Planning Zoning PC Fee:
'
'..
100 Civic Center Drive, Newport Beach, CA 92660.
2
F 2 0 1 9 0 0 7 0
Special Conditions:
$0.00
Project No: 0286-2019
0
Setback- Front:
Permit Counter Phone (949)644-3288
$0.00
FlaodWne: ° o ° o
$0.00
Rear.
$0.00 ..
''..
Bldd 80 n?ders
Y
Left:
o ccoco�
$446.00
Right:
$0.00 Fee Due at Permit Issuance ;
$446.00
Inspection Requests Phone (949)644-3255
Job Address: 1100 EBBTIDERD NB
Description: SFR FIRE SPRINKLERS - (X2018.1941) 12 HEADS
Inspector Area:.4
Legal Description:
N TR 2202 LOT 75
'..
Owner:
HANSEN GREG & KARA
Contractor:
FIREPROOF FIRE PROTECTION
Architect:
Address:
, 1100 EBBTIDE RD
Address:-
1101 KINGSTON DR
Address:
-
CDM 92625.
LA HABRA CA 90631
Phone:
Phone:
714.476.5370
Phone:
State Lia
Applicant:
CASEY MONTY
Con State Lie:
876004
Engineer.
Address:
1101 KINGSTON DR
Lie Expire:
04130/2020
Address:
LA HABRA CA 90631
Bus Lie:
BT30040107-
Phone:
- 714-476-5370
Lic,.Exp Date:
08131/2019
Phone:
State Lia
Code Edit : 2016
Worker's Compensation Insurance
Designer:
CASEY MONTY.
Type of Construction:
V-BSPR
Carrier: NORGUARD INS CO
Address:
1101 KINGSTON DR
Occupancy Group:
R31U
Policy No: MOWC901180
$0.00 Records Management:
LA HABRA CA 90631
Added /New sq.ft. Bldg:
0
Expire: 02/15/2019
Phone:
Added /New sq. ft. Garage:
0
Planning Zoning PC Fee:
$0.00
'..
No of Stories:
2
Issued Date: 02/0512019
Special Conditions:
$0.00
No of Units : a ° °
0
Setback- Front:
$0.00
$0.00
FlaodWne: ° o ° o
$0.00
Rear.
$0.00 ..
''..
Bldd 80 n?ders
Y
Left:
o ccoco�
$446.00
Right:
$0.00 Fee Due at Permit Issuance ;
$446.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL
OYI OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES00000
® Construction Na)uabore
$1,200.00
Bu4ing PC-F.'.ee -
$202.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
$4.00
m. �BOding Ovekime`PC Fee:
$0.00
Planning Counter Review:
$0.00
° BuAing`Eiderftion Fee :
$0.00
Planning Zoning PC Fee:
$0.00
'..
o Building lnvatfigation Fee:
$0.00
$0.00
`Hlif'Plan Check Fee:
$0.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit F.sar.c
$0.00
Public Works Traffic Plan Check Fee;
$0.00 ..
''..
Building Permits,96 :
$240.00
TOTAL FEE :'
$446.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance ;
$446.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL
OYI OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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) 1 have placed next to the applicable its '(a)
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
is 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
Irofessions 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
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 U portions of the work, and the structure is not intended or offered for sale (Section 7044,
iusiness 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
nprovements 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
nproved for the purpose of sale).
1 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
pply 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:
ly 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
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and
Irofessions 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
.ICENSED CONTRACTOR'S DECLARATION
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
nd effect.
icense Class License No Da Contractor Signatur
YORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA ($100,000), IN ADDITION TO THE
OST 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:
I 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 th(
e rman ce of the work for which this permit is issued. Policy No.
�I Iva
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'tio� ws' compeHs'atipr
is ante carrier and policy number are: ° ° *00000
crier Policy Number Expiration Date °
arae of Agent Phone# ° •O°UC°
]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 RtCalijornia, g Nd agrer
tat, if I should becomet to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. • • ° ° ° ° °
ignature of Applicanf:§§. �' _ _ D2��'\�\` • _
ECLARATION REGAltDING CONSTRUCT ENDING AGENCY
•••.' °°
hereby affirm under penalty of perjury that th a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Bnder's Name Lender's Address ° °
y'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 countylto gp&kh"bove-identified property for inspection purposes.
ACTION DATE BY
ECLARATION OF COMPUANCEWITN CODE VY
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