HomeMy WebLinkAboutF2019-0029 - Permits$' City of Newport Beach - Building Division IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
a 100 Civic Center Drive, Newport Beach, CA 0263°0° ° ° ® FIRE Permit: F2019-0029
Permit Counter Phone (9AA9)g41,328f�.
. ®. • • e Project No: 0136-2019
° •
s e o e
o• a oee ee°
Inspection Requests Phone (949)644-3255
e o em •
e • m —w'�
Job Address: 2865 E COAST H WY NB e® m e° a e o m ° e° o m m •®°
• e a ee
Description: COMM- U/G FIRE LINE
InspectorArea: Legal Description: TR 323 LOT 6 BILK F AND CORONA DEL MAR LOTS 113/5 ELK 534
Owner: OCEAN RIDGE PLAZA LLC
Address: 2865 E COAST HWY
Contractor: PRECISION FIRE SYSTEMS
Address: LA PAZ RD #272 Architect:
CDM CA 92825 Address:
Phone: ALISO VIEJO CA 92656
Phone: 949-337-3317
Applicant: MCSTAY MICHAEL Phone: State Lic:
Address: 27068 LA PAZ RD #212 Con State Lic: 906248
ALSO VIEJO CA 92656 Lic Expire: 1 113 012 01 9 Engineer:
Phone: 949-337-3317 Bus Lic: BT30Address:
Lic Exp Date: 09/30/2019/2OJg
Code Edit: 2016 Phone: State Lic:
Type of Construction: V -B Worker's Compensation Insurance
Occupancy Group: U Carrier: EXEMPT NO EMPLOYEES Designer:
Added /New sq.ft. Bldg: 0 Policy No: Address:
Added /New sq. ft. Garage: 0 Expire:
No of Stories:Phone:
No of Units
0 Issued Date: 01/16/2019
: 0 Setback- Front: Special Conditions:
Flood Zone:
Bldg Sprinklers: Y Rear:
Left:
Right:
JR
Construction Valuation: $25,000.00 FEES
Building PC Fee : $0.00
Building Overtime PC Fee: Fire Residential Alarm PC Fee: $0.00
Building Extention Fee : $0.00 Planning Counter Review : .Records Management : $4.00
$0.00 Planning Zoning PC Fee : $0.00
Building Investigation Fee : $0.00 $0.00
Fire Plan Check Fee: $3$0.00
Fire Permit Fee : Public Works PC Fee : $41 25 $0.00
Building Permit Fee : $3$0.00 Public Works Traffic Plan Check Fee; $0.00
$0.00 $0.00
TOTAL FEE : $762.25 Plan Check Fee
$0.00 Fee Due at Permit Issuance : $762.25
PROCESSED BY:
ZONING APPROVAL: OTHER DEPARTMENT:
—
FIRE APPROVAL PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
......... .. ...
YNER-BUILDER DECLARATION ,
I hereby affirm under penalty of perjury ' 'rior to its issuance, also requires the applicant for
that I am exempt from the Contractors' State License Law for the reason(s) indicate[�balow by the oheckmark(e) 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, demollsh,orrptgri aro/ smentirn, P
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (CRd'ptEr'9'(codimending wlth S@CtTon 7000) of Division 3 of the Business and
ofessions Code) or that he or she is exempt from licensure and the basis far the alleged exemption. Any violation of Section 7031.5 by any applicant a permit subjects the applicant to a civil penalty of
t more than five hundred dollars ($500). portions of the work and4he structure ts•not intrideel ot, offered for sale (Section 7044,
ees' ar ersnai effort, builds:or improves the property, provided that the
1 I, as owner of the property, or my employees with wages as their sole compensation, will dor o all of rt (_) p • ' ' bdr Ln of proving that it was not built or
ner-BU'der I havedae d p g
isiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through empiD>✓ P
iprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completidh, jpe,(nd Professions Code: The Y :^fl �
!proved for the purpose of sale). usiness
ply to an owner
of the
er property,
who builds exclusively
contracting
theroonh licensed
who contracts for the projects with a licensed Contract r pursuant to the Contractors' State License rLaw)s' State License Law does no
y I am exempt from licensure under the Contractors' State License Law for the following reason:ion !or to )!cable law, Section 7044 of the Business and
m signature below I acknowledge that, except fort h personalbeen constructed in it I must entirety by resided licensed tcontracto s. I understand that a Copy of the applicable
law, covered by this permit, I cannot legal)
Y Y
a_II a structure that I have built as an owner -builder if it has not Date
rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.90v/cal8w .
ignature of Property Owner or Authorized Agentnd license is full force
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provi
hesions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr sion
theind effect. Date
.!cense Class /� Contractor Signature
License No
VOSTIOF COMPERE: TO NCURE WOR AS RKERS' CODED FORM SECTIOMPENSATION N 77 IS THE LA"LL AND $HALL SUBJECT AN EMPLOYER TO BOUNILAWI R CODE, NTEREST, AND ATTORNEY'S F EES. PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADDITION TO THE
YORKERS' COMPENSATION DECLARATION
DAMAGE
hereby affirm under penalty of perjury one of the following declarations:
1 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 t
ierformance of the work for which this permit is issued. Policy No.
:31 have 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' compensatio
insurance carrier and policy number are: Expiration Dater
Policy Number Phone #
akee of Agent
rtify that, in the performanceem X of ork is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, an ag
Ithat, f I should become sub e w s' ceR-pnyvisions of Se 3700 of the Labor Code, I shall forthwith comply with those Date provisions �Z %
ignature of Applica
iECLARATION REGARD CONSTRUCTION LENDING AGI
hereby affirm under penalty of perjury that there is a construction lending agency for Lender'of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Address
.ender's Name
ly my signature below, I certify to each of the following:
1 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 county to enter the above -identified property for inspection purposes. r Na
representatives —
Print propertyowners or Authorized Agent's
DATE
va REGULATIONS
BY FEDERALREGf%LATIONSFARFfi10F7
AQMD RULE 1403.
❑ I SUBMITTEDASBESTOS KD71F/CATION T0.
XPIRED
❑ EPA
'ANCELLED
❑ AQMD
RON t5 NOT APPLICABLE TO
HTENDED
0 PRSBESTOS OPOSED DEMOLITION.
=INAL
dTFOE
SIGNATURE
OCCUPANCYISSUED