HomeMy WebLinkAboutF2018-0283 - Permits<=r, City of Newport Beach - Building Division
off. 100 Civic Center Drive, Newport Beach, CA 92660
E 'x Permit Counter Phone (949)644-3288
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Job Address: 4545 PERHAM RD NB
Inspector Area: 5
Owner: O'TOOLE BRIAN
Address: 3419 VIA LIDO #483
NEWPORT BEACH CA 92663
Phone: 949-719-9010
Applicant:
FIREPROOF FIRE PROTECTION
Address:
1101 KINGSTON DR
Address:
LA HABRA CA 90631
Phone:
714.476-5370
Code Edit: 2016
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
V-BSPR
R31U
0
0
IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII II FIRE Permit: F2018-0283
F 2 8 1 8 6 2 6 3 Project No : 1137-2018
Inspection Requests Phone (949)644-3255
Description: SFR NEW FIRE SPRINKLER SYSTEM 40 HEADS (X2017-2530)
Legal Description:
N TR 3357 LOT 118
Contractor:
FIREPROOF FIRE PROTECTION
Address:
1101 KINGSTON DR
NORGUARD INS CO
LA HABRA CA 90631
Phone:
714-476-5370
Con State Lie: 876004
Lie Expire: 04/30/2020
Bus Lie:
BT30040107
Lie Exp Date:
08131/2018
Worker's Compensation Insurance
Carrier:
NORGUARD INS CO
Policy No:
MOWC901180
Expire:
0 211 512 01 9
2 Issued Date: 05/14/2018
0 Setback- Front:
Rear:
N Left:
Right:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
State Lie:
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FEES°m
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Construction Valuation:
State Lie:
e eee+r
Building PC Fee:
o m
CASEY MONTY
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1101 KINGSTON DR
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Planning Counter Review:
LA HABRA CA 90631s
Building Extention Fee :
714-476.5370
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$0.00
Fire Plan Check Fee:
$0.00
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$0.00
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0
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PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: T APPROVAL TO ISSUE: (v
PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES°m
0 0 °
o
Construction Valuation:
$4,000.00
Building PC Fee:
$190.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
$4.00
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 :
$419.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$419.00
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: T APPROVAL TO ISSUE: (v
PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
IWNER-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)
lection 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
rofessions 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 U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
usiness 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).
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 ncf
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:
y 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 legall)
-II 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
rofessions Code, is -available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.htmi.
ignature of Property Owner or Authorized Agent Date
ICENSED CONTRACTOR'S DECLARATION
hereby affirm urill penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business andofessions Code, and my ' ense is in full force
nd effect. 4i
icense.Class ' • •' License No Date 5 - Contractor Signature C
A5ARERS' d6FAPbNSATION DECLARATION
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO O HUNDRED THOUSANDLIAR $100,0001, IN ADDITION TO THE
DBTsg tOMPENSA7TON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Zereby affirm grbe LgValty of perjury one of the following declarations:
i have and will ma, tain 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
>;rpance of TlVtork for which this permit is issued. Policy No.
....
K. a 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' compensatiol
a alloe carrier and policy number are:
arner : .....: Policy Number Expiration Date
a 0Agent Phone #
:ARify that, Tr6fte;Arformance of the work for which this permit is issued, I shall not employ any person in any manner so as to become sub' ct to the workers' compensation laws of California, and
if I should become hubject to the workers' cdrnpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thoseovisions.
Signature of Applicant
DECLARATION REG DING CONSTRUCTI ENDING AGENCY
I hereby affirm under p natty of perjury that t s a construction lending agency
for the performance of the work for which this permit is sued (Section 3097, Civil
Code)..
Lender's Name
Lender's Address
By 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 re ng to building construction.
I authorize representatives of this city or county to er the above -identified prope for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nae _
ate
ACTION OATS BY
DECLARATION OF COMPLIANCEWITN CODE OF
FEDERAL REGULATjONSPART61'OFTITL.E40AND
AQMD RULE 1403.
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PERMITEXPIRED
PERMIT CANCELLED
❑ EPA
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❑ ASBESTOS NOTIRCADONIS NOT APPLICABLE TO
PERMITEXTENDED
PERMIT FINAL
PROPOSED DEMOLITION.
CERTIFICAT€OF
OCCUPANCYISSUED
SIGNATURE:
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