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HomeMy WebLinkAboutF2019-0386 - Permits (2)City of Newport Beach -Building Division IIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIII�II II ` 4 - 100 Civic Center Drive, Newport Beach, CA 92660 F. 2 0 1 9 0 3 8 6 h( _ Permit Counter Phone(949)644-3288 FIRE Permit: F2019-0386 Project No:1541-2019 Inspection Requests Phone (949)644-3255 Job Address: 613. NARCISSUS AVE NB Worker's Compensation Insurance Description: SFR FIRE SPRINKLER SYSTEM 39 HEADS (X201 B-3431) Inspector Area: 5 - Legal Description: CORONA DEL MAR BLK 640 LOT 13 Address: Owner WATERPOINTE PROPERTIES Contractor: FIREPROOF FIRE PROTECTION Architect: Address: 610 NEWPORT CENTER DR STE 890 Address: 1101 KINGSTON DR Address: $0.00 NEWPORT BEACH, CA 92660 $0.00 LA HABRA CA 90631 $0.00 Phone: - Phone: 714476.5370 Phone: Applicant: CASEY MONTY Con State Lie: 876004 Engineer: Address: 1101 KINGSTON DR Lie Expire: 04130/2020 Address: $446.00 LA HABRA, CA 90631 Bus Lic:. BT30040107 °o•ooc Phone: 714476-5370 Lie Exp Date:. 0713112019 Phone: State Lie: State Lie: Code Edit: 2016 Worker's Compensation Insurance Designer.. CASEY MONTY Type of Construction: V -B -SPR Carrier: NORGUARD INS CO Address: 1101 KINGSTON DR Occupancy Group:. R3/U Policy No: MOWC002760 Fire Residential Alarm PC Fee: LA HABRA, CA 90631 Added /New sq.ft. Bldg: 0 Expire: 0211512020 Phone: 714476-5370 Added /New sq. ft. Garage: 0 No of Stories: 3 Issued Date: 07/09/2019 Special Conditions: No of Units : 0 Setback- Front: .Flood Zone: Rear: Bldg Sprinklers: N Left: Right: - PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: L/Uy v OTHER DEPARTMENT: PLAN CHECKED BY:: A -TI APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION eo•o FEES Construction Valuation: $3,900.00 OnnOn6 Building PC Fee: $202.00 Fire Residential Alarm PC Fee: $0.00 Records Management 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 n om - Fire Plan Check Fee: $0.00 Public Works PC Fee: $0.00 Fire Permit Fee : $0.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $240.00 n • o • o TOTAL FEE : $446.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: L/Uy v OTHER DEPARTMENT: PLAN CHECKED BY:: A -TI APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION eo•o + o .Deno OnnOn6 J • o OG m O • • n n ommo •• o ®Dom o Doc n om o0 0 c e o eooco Doo® m om000 n ece000 n • o • o cooann o 0 0 °o•ooc 0 oc c o o 000c ococo $4.00 $0.00 $0.00 $446.00 INER-BUILDER DECLARATION _ A�, 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 item(s) fiction 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 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 ifessions 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. 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, :iness 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 )rovements 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 )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 fly to an ownerof propertywho 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: 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 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 ,fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Property Owner or Authorized Agent Date )ENSED GONYRACTOR'S DECLARATION :reby affirm OrMl penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ction 7000) of Division 3 of the Business and P ofessions Code, and myl nse is in full force I.affect. ense Class: • License No Date V Contractor Signature )RK4ERS' COMPENSATION DECLARATION tNING: FAILURC-•IO5E�(URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRI NAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAR E'10 0001, IN ADDITION TO THE IT OF:COMPEITS(�'jIQGI, uAMAGE5 AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. �reby affirm ugrj,er penalty of perjury one of the following declarations: lVeme and wiNinaintain 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 thl kJ11hance of thawork for which this permit is issued. Policy No. - and vYl%oMain 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' carrier and policy number are: Agent •••• certify that, in the p� , if I should become Policy Number Expiration Date Phone # of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become su he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those nature of Applicant CLARATION REGA DING CONSTRUCTION LENWG AGENCY, rreby affirm undernalty of perjury that there is a ons coon lending agency for the performance of the work for which this permit is Ider's Name Lender's Address 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 count�rdinances and state laws relating to building construction. I authorize representatives of this city or county to teriffia t ove-identified property for inspection purposes. of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent': ACLTON DATE BY TION Of COMPLIANCEWITH CODE OF RAL REGULATIONS PART 61 OF TITLE 40 AND 7 SUBM7TTEDASBESTOS M077FICATION TO: © EPA IJ AQMD ASBESTOS N07IRCATTONIS NOT APPLICABLE TO OCCUPANCY QSUED / I Y I I SIGNATURE: the workers' compensation laws of California, and (Section 3097, Civil Code). I ool ❑❑❑❑ ❑❑ W) U �E M UO IL La � a CIO ani ®7° �zo Q rn O Q ~U � FTy A a yC� U o N a� •o U U CL O ool ❑❑❑❑ ❑❑ •" N c rn C, �E s� IL La � a ani E a� Q ~U c N a� •o CL 0 E IL $ oZ� t'i p E 0 Ua e CL rn t m m U 8 a E v y 0 N F E � ❑ m .vo! 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