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HomeMy WebLinkAboutF2020-0208 - Permitsrwwr�r City of Newport Beach - Building Division IIIIIIIIIIII'IIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII II #�pP� 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 0 0 2 0 8 Permit Counter Phone (949)644-3288 cr4irouK'� Job Address: 21159 NEWPORT COAST DR NB Inspector Area: FIRE Owner: PLAZA MANOR ASSOCIATES Address: 550 NEWPORT CENTER DR ALL STAR PLUMBING & FIRE SPRINKLER COMPANY NEWPORT BEACH, CA. 92660 Phone: Address: Applicant: SIRIGNANO KEITH Address: 22672 LAMBERT ST #619 949-470-0072 LAKE FOREST CA 92630 Phone: 949-521-2460 Code Edit: 2019 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 B 0 0 FIRE Permit: F2020-0208 Project No : 0822-2020 Inspection Requests Phone (949)644-3255 Description: COMM FIRE SPRINKLER TI (X2019.4032) 17 HEADS "NEWPORT ,r tJ I J-AArL, "OSP I'CALr Legal Description: P BK 318 PG 27 PAR 2 FEES Contractor: ALL STAR PLUMBING & FIRE SPRINKLER COMPANY Address: P O BOX 1413 Address: LAKE FOREST CA 92609 Building PC Fee: Phone: 949-470-0072 Phone: Con State Lic: 715588 Engineer: Lic Expire: 0813112021 Address: Bus Lic: BT30059737 Planning Zoning PC Fee : Lic Exp Date: 0713112020 Phone: Worker's Compensation Insurance Designer: Carrier: BENCHMARK INS CO Address: Policy No: CSTS018455 $0.00 Expire: 0210512021 Phone: 1 Issued Date: 0512612020 Special Conditions: 0 Setback- Front: Rear: Y Left: Right: Architect: INS State Lic: ' o� o State Lic: SIRIGNANO EDWARD 0 22672 LAMBERT ST #619 LAKE FOREST CA 92630 ' ° - ao uo°; PJJJ JJ PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: �K 1J7— OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION FEES Construction Valuation: $1,700.00 Building PC Fee: $0.00 Fire Residential Alarm PC Fee: $0.00 Records Management : $2.00 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: $170.00 Public Works PC Fee: $0.00 $0.00 Fire Permit as : $224.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee. $0.00 TOTAL FEE : $396.00 Plan Check Fee: $396.00 Fee Due at Permit Issuance: $0.00 PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: �K 1J7— 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[ 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 ftem(s) :tion 7031..5, Business and Prolessions Code: Any city or county that requires a permit to construct,atter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for permit to file asigned 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 'essior s Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any Notation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of more than five hundred dollars 0001• 1, as owner of the property, or my employees with wages as their sols compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, !mess 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 thatthe rovements 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 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' Stale License Lawdoes not ly 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). y my signature below I acknowledge that, except for my personal residence In which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, 1 cannot legalh ell a stmctore, that I have built as an owner -builder if it has not been Constructed in its entirety by licensed rontractors. I understand that a copy of the applicable law, Section 7044 of the Business and professions Code, is available upon request when this application is submitted or at the following Web site:http:f/ww'w.leginfo.ca.gov/calaw,html. Ilgnature of Property Owner or Authorized Agent Date .ICENSED CONTP.A.CTOR'S DECLARATION . hereby affirm under wriahv of perjury that I am licensed under provisions of Chapter 9"(commencing wgth SRrAion7000) of Division 3 of Business spa P, ssions ,ode, and my license is infuii force nd effect. [�7�, //// { (cense class HT1, - 3� _License No % 1 5 SB Date �/S a Contractor Signature VlC WORKERS' COMPENSATION DECLARA'nON ¢¢ ss �ARNINGr FAILURE TO SECURE WORKERS'- COMPENSATION COVERAGE IS UNLAWFUI, AND SHALL SUBJECT -AN- EMPLOXRAsCRIMINAL PENALTIESANO CM+L RNES'UP TO ONCHUNbRED=T OU5�LNDOOLIARS (51eD,e0oj, IN A4prfpN-TO=THE OST OP COMPENSATION, MMAGES AS PROVIDED, FOR IN SECTION 37W OFTTiE LAaOR COOS, INTEREST, ANDATrORNET'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. edortnance of the work forwhich this psnnit is issued. Policy No - do 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' compensatim Ist*tonce carrier and policy number are: :arrier B L M a /< Policy Number C ,S? d Q 5 Q S Expiration Date( -- lame of Agent Phone 4 JI certify that, in the perfann nce of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to a workers' compensation laws of California, and agre, tat, ff I should became ubj t he wor ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro 'sf s. :dgnature of Applioant Date —• rECLARATION REGARWNIG ONISQCYON LENDING AGENCY hereby affirm under pe of perjury iha there is a construction lending agency forthe performance of the work forwhich this permit is issued (41n 3097, Civil Code). .ender's Name Lender's Address ly my signature below, 1 certify to each of thefollowing: I am the property owner or authorized to act on the property owner's behalf. 1 have read this application and the information I have provided is coned. I agree to comply with all applicable city and cc ordinances and state laws relating to building construction. I authorize representatives of this city or cou en e a vUdentified property for inspection purposes. S--CL-x signature of Property Owner orAutharized A ant Print Property Owner's or Authorized Agent's Name r io n ti Date 17 ACTION DATE BY DECLA LEAN t4? HMDEDF FOR OFRCEUSE ONLY FEDERAL REGUL477ONSPART(if OF71TLE40AND AQMD RULE 1403. ❑ ISU&Mf7TEDA5EESTOSNO77RcATlONTO: ❑ EPA 13 AQMD ❑ ASBESTOS MORRCA77ONISNOTAPPLICABLETO PROPOSED DEMOUTIOM SIGNATURE: PERNf7EXP1RE0 PERMITCANCELLED r PERMFTEx7ENDE0 PERMfrF1NAL .i '' CERTIFICATEOF OCCUPANCYlSSUED