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HomeMy WebLinkAboutF2015-0378 - Permitseww,e City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II o fl 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 5 0 3 7 8 Permit Counter Phone (949)644-3288 H u, FIRE Permit: F2015-0378 Project No : 1395-2015 Inspection Requests Phone (949)644-3255 Job Address: 920 W OCEAN FRONT NB Description: SFR - (54) FIRE SPRINKLER HEADS FOR NEW SFR (X2011-1116) Inspector Area: 1 Legal Description: N TR 234 BLK 9 LOT 6 Owner: LAINER MARK Contractor: PRIORITY ONE FIRE PROT Architect: Address: 17527 MAGNOLIA BLVD Address: 4595 VIA DE LA PLAZA Address: ENCINO, CA 91316 YORBA LINDA CA 92886 Phone: Phone: 714-716-6671 Phone: State Lic: Applicant: TONY/PRIORITY 1 FIRE Address: 18340 YORBA LINDA Worker's Compensation Insurance YORBA LINDA CA 92886 Phone: 714-696-6790 Code Edit: 2013 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 -B -SPR R3/U 0 0 Con State Lic: 988747 Lic Expire: 11/30/2015 Bus Lic: BT30047111 Lic Exp Date: 05/30/2016 Worker's Compensation Insurance Carrier: WIC EXEMPT Policy No: (NO EMPLOYEES) Expire: Building PC Fee: 0 Issued Date: 0 6/3012 01 5 0 Setback- Front: 2 Rear: Y Left: Right: Engineer: Address: Phone: State Lic: Designer: PRIORITY 1 FIRE Address: 18340 YORBA LINDA YORBA LINDA CA 92886 Phone: 714.696.6790 - Special Conditions: OOmrr^ o oeoco 0o n m m , 0 n 00 n 0 o n m o o c om0000 m PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: 'Q4 14- PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION FEES Construction Valuation: $7,800.00 Building PC Fee: $136.08 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 : $189.00 TOTAL FEE : $329.08 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $329.08 PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: 'Q4 14- PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID 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 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 improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner�of t4%property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business andProfessionsCode: The Contractors' State License Law does not apply an owgr rbf BPoperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). - • 1`94 exempt from ycensure under the Contractors' State License Law for the following reason: 8y my signatumbeloml 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 legal) 14a educture 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 iL4f@SSions Codeeis available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Sigynature of PrpPeVQwner or Authorized Agent Date LFRASED CCOPRACTOR'S DECLARATION t harebyaffirm Bnderpenalty 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 Slid elect. : ' •' eigr%%Class License No Date '-3 0 Contractor Signature WORKERS' GOMAENSATION DECLARATION "i,FAILURg ZSS5 URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTH ND DOLLARS ($100,000), IN ADDITION TO THE 90ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 performance of the work for which this permit is issued. Policy No. I 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: 'er Policy Number Expiration Date ame fAgent Phone# 'fy that, in the performance of the work forwhich 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 that, if should become s�uubbJ'ject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr�o/v�",cions. j� `— 3� ignature of Applicant /\ter--��—i Date/\ 6 DECLARATION REG R CONSTRUCT ENDING AGENCY I hereby affirm under penalty of perjury -t there is a construction lending agency for the performance of the work for which this permit is issued (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 relating to building construction. 6�3G I authorize representatives of this city or county a identified property for inspection purposes. cYw�late (� Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam WLJ.-444JJJ ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OFTIILE40AND AQMDROLE 1403. PERMIT EXPfRED I SUBMTTEDASBESTOS N071FICATIONTO: PERMITCANCELLED ❑ EPA ❑ AQMD [I ASBESTOS N077RCARONIS NOT APPLICABLE TO PERMIT EXTENDED PERMIT FINAL (�— �, 3 / %V PROPOSED DEMOLITION. C€RTIRCATEOF OCCUPANCYISSUED SIGNATURE., I m\ 0000 00 0 1100 00 a 4 Cz ��ZO t I a =� LU g �Ty Aid d ,K n � 5 cm. m a m CL F .a m 75Z .6 o�E _� U' = = xaa� o� z cd .c d ti ai dci I > o O cd .c u1 � ed i h� a.c ti o4 gai � U t IV �xj two 4 0 72 .71 ti y C7,❑© �4R��.��� ■ ■ ■ ■ ■ ■■ ■ ■ ■ ■ ■