HomeMy WebLinkAboutf2022-0147 - Permits`'r°p� City of Newport Beach - Building Division II��IIIIIIIIIIIIIIIIIII�II�IIIIIIIIIIIIIIII II FIRE Permit: F2022-0147
cs� 100 Civic Center Drive, Newport Beach, CA 92660 2 0 2 2 0 1 4 7
p Project No : 0699-2022
�:,�i Permit Counter Phone (949)644-3288
r'��JtaK�4 Inspection Requests Phone (949)644-3255
Job Address: 610 NEWPORT CENTER DR NB St: 1 Ft:
12
Description: COMM FIRE SPRINKLER TI W/ (5) HEADS. (X2022-0782)
Inspector Area: FIRE
Legal Description:
P BK 295 PG 33 PAR 4
Owner: 610 NEWPORT CENTER DR LLC
Contractor:
FIRE PROT SPECIALISTS
Architect:
Address: PO BOX 2450
Address:
2810 E MIRALOMA AVE
Address:
NEWPORT BEACH, CA 92658
ANAHEIM CA 92806
Phone: 949-720-2400
Phone:
714-635-6600
Phone:
State Lic:
Applicant: YAM MARK
Con State Lic:
464915
Engineer:
Address: 392 N LEMKY CT
Lic Expire:
10/3112022
Address:
ORANGE, CA 92867
Bus Lic:
BT30042894
Phone: 626-767-2320
Lic Exp Date:
05131/2023
Phone:
State Lic:
Code Edit: 2019
Worker's Compensation
Insurance
Designer:
ANDERSON ROBERT
Type of Construction: I-A-SPR
Carrier:
COMP WEST INS. CO.
Address:
2810 E MIRALOMA AV
Occupancy Group: B
Policy No:
WCV5502952
ANAHEIM CA 92806
Added /New sq.ft. Bldg: 414
Expire:
12/02/2022
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 18
Issued Date: 06/27/2022
Special Conditions:
X2022-0782
No of Units : 0
Setback- Front:
Flood Zone: X
Bldg Sprinklers: Y
Rear:
Left:
Right
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FEES
Construction Valuation:
$1,250.00
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:
$130.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee :
$198.25
Public Works Traffic Plan Check Fee;
$0.00
Building Permit as :
$0.00
TOTAL FEE :
$330.25
Plan Check Fee:
$130.00 Fee Due at Permit Issuance :
$200.25
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
�9 c
I�ERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
� ea Aso
yea ¢ee a � se ce® sxo
JWNER-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).
❑ 1, 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 legal)
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:/Iw .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 000) f Division 3 of the Business and Profess! ns Code, nd li ense is in full force
and effect.
License Class License No Date � 2—Z Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR D THOUSAND DOLLARS ($100,00D), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
QI t)ave 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 the
p6UKUnance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
1e of Agent
certify that, in the performance of the work for
if I should become subject totp"orkers' co
of Applicant
Policy Number
Date
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
;provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions: i
Ireby affirm under penalty of derjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section
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 countly ordinances and at laws relating to building construction.
I authorize representatives of this city or county t6knt)gthe abpv9Ader0fiE4,property for inspection purposes.
of Property
or Authorized Agent's Name
Civil Code).
ACTION
DATE
BY
DECLARATION OF COMPLIANCE MTH CODE OF
1 FOR OFFICE USE ONLY
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