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Home My WebLink Aboutf2022-0203 - Permits�r,r1 City of Newport Beach - Building Division 1pi111111111p1111p11111111111p1111111p111111 JillFIRE Permit: F2022-0203 _: 4+ 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 2 0 3 Project No : 1029-2022 - w' n Permit Counter Phone (949)644-3288 9rri�.�tt'+ Inspection Requests Phone (949)644-3255 BE N I A- AA3 A - Job Address: 4250 BIRCH ST NB Description: COMM FIRE SPRINKLER TI -11 HEADS (X2021-2481) Inspector Area: FIRE Owner: BENI INVESTMENTS LLC Address: 21500 BISCAYNE BLVD AVENTURA FL 33180 Phone: Applicant: AVILA CHRIS Address: 23891 VIA FABRICANTE UNIT 615 MISSION VIEJO CA 92691 Phone: 949-302-4259 Code Edit : 2019 Type of Construction: V-BSPR Occupancy Group: B Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Flood Zone: X Bldg Sprinklers: Y Construction Valuation: Building PC Fee, Building Overtime PC Fee: Building Extention Fee : Building Investigation Fee Fire Plan Check Fee: Fire Permit Fee : Building Permit Fee TOTALFEE PROCESSED BY: • _ ZONING APPROVAL;." $2,750.00 FIRE APPROVAL: )V G ^ O % Q Legal Description: P BK 45 PG 25 PAR 2 Contractor: COMPLETE FIRE SOLUTIONS INC Address: 23891 VIA FABRICANTE UNIT 615 MISSION VIEJO CA 92691 Phone: 949-202-4259 Con State Lie: 1031106 Lie Expire: 0913012023 Bus Lie: BT30078511 Lie Exp Date: 0413012023 Worker's Compensation Insurance Carrier: TECHNOLOGY INS CO INC Policy No: TWC4021418 Expire: 07/01/2022 Issued Date: 04/1912022 Setback- Front: Rear: Left: Right: $0.00 $0.00 $0.00 $0.00 $142.00 $217.75 $0.00 $361.75 FEES Fire Residential Alarm PC Fee Planning Counter Review: Planning Zoning PC Fee : Public Works PC Fee : Public Works Traffic Plan Check Fee; Plan Check Fee : Architect: Address: Phone: State Lie: Engineer: Address: Phone: State Lie: Designer: "ILA CHRIS Address: 23891 VIA FABRICANTE UNIT 615 ,MISSION VIEJO CA 926914 Phone: Special Conditions: - 'SP�Ec,Tofk $0.00 Records Management: $2.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 bLC1�:7•]�9d:iY�41�:YF PLAN CHECKED BY:: APPROVAL TO ISSUE: Fee Due at Permit Issuance : $361.75 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 -Builder will have the burden of proving that it was not built or improved 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 apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http:/Avww.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProIF C de, and my license is in full force and effect. License Class License No Date �- Contractor Signatu � .. WORKERS' COMPENSATION DECLARATION �G WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE COST 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( IT of the work for which this permit is issued. Policy No. Onsurt, ve 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' compensatior cecarrier and policy number are: Policy Number Date ie of Agent Phone # certify that, in the performance of the work for which 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. , of Applicant DECLARATION REGARYMG CONSTRUCTION LENDING AGENCY V I hereby affirm under pe alty of perjury that 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 owners 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 toe er t ab ve-identified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name uDate ACTION DATE BY DECLARATION OF COMPLIANCE V4ITN CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART.6I OF TITLE40AND AQMD RULE 1403. • • • ••� •�• "�• "+• •. PERMITEXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD . • • " . . + • ' • " PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION, . .. �� •"• •"� a s•. s PERMIT FINAL .jam CERTIFICATEOF OCCUPAPICYISSUED SIGNATURE: •• •• •• �° e