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HomeMy WebLinkAboutf2021-0280 - Permits>; City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 ct �tac>A Job Address: 125 26TH ST NB Inspector Area: 1 Owner: SERRA BRIAN & VICKI Address: 125 26TH ST NEWPORT BEACH, CA 92663 Phone: Applicant: SUMMIT FIRE PROTECTION INC Address: 520 TEXAS STREET REDLANDS CA Phone: 909-793-0676 Code Edit : 2019 Type of Construction: V-BSPR Occupancy Group: R3IU Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 3 No of Units : 0 Flood Zone: Bldg Sprinklers: N "F2021-0280* FIRE Permit: F2021-0280 Project No : 1515-2021 NS PECTA O Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLER SYSTEMS 10 HEADS (X2020-1086) Legal Description: NEWPORT BEACH CITY BILK 26 LOT 23 Contractor: SUMMIT FIRE PROTECTION INC Architect: Address: 520 TEXAS STREET Address: .... REDLANDS CA Phone: Phone: State Lie: • ° Con State Lie: 362801 Engineer: Lie Expire: 0212812023 Address: a• ° Bus Lie: BT30075789 o 0 0 Lie Exp Date: 0713012022 Phone: State Lie: .... • ° •• Worker's Compensation Insurance Designer: °®e• • • ° • Carrier: STATE COMP Address: Policy No: 9027856 Expire: 10102/2021 Phone: Issued Date: 07/0612021 Special Conditions: • ° cooea• • Setback- Front: o ..... .... Rear: Left: Right: FEES Construction Valuation: $8,000.00 Building PC Fee: $222.00 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 as: $269.00 TOTAL FEE : $495.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $496.00 PROCESSED BY: 1 �" OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: l PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION ER -BUILDER 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) action 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 ofessions 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 t 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, isiness 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 provements 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 proved 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 ply 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). I am exempt from Iicensure 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 II a structure th9Pl'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 bMlions Cgde, "available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. ]nature of Property Owner or Authorized Agent Date CE%SED CONTRACTOR'S DECLARATION ereby affirm y i ¢penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and rofessions Code, and my license is Birce 0 ftct. '..n� r7 ` sense Class s a / � License No 31a Z 120 I Dat 1 la ,Z Contractor Signature C/ DR4ERS' f 171�(le£NSATION DECLARATION MING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOUSAND DOLLARS ($100,000I, IN ADDITION TO THE 57915 COMPENSA*rION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. b//rea affirm dhder&nalty of perjury one of the following declarations: `?}lave 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 rfe0ance of lhexark 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' compensatior urance carrier and policy number are: Policy Number Expiration Date of Agent Phone #_ I certify that, in the performance of the work for which this perm' is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and t, if I should become /�Jbject to the workers' compensatio ns of Section 3700 of the Labor Code, I shall forthwith comply with those p ovl ons. mature of AoolicantY /L��. i .rw �� Date ? ` ''J 4, /Z / 1 hereby affirm under ena o er u that there is a construction lending agency for the performance of the work for which this permit is issue/ r DECLARATION REG ING C S RUCTION L DING AGENCY y j ry g g y p p d (S ction 3097, Civil Code). Lender's Name Lender's Address By my signature below, I ceffify 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 Ktyentr rdinances and state laws rela' to building construction. I authorize representatives of this city or couthe ove-identified p y for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name IVA"� J� ` Date ACTION DATE BY DECLARATION OF COMPLIANCE KgTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 6f OF T17LE40AND AQMD RULE 1402 PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS N071FICATION TO:: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENOED ❑ ASBESTOS NOFFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTMICATEOF SIGNATURE: OCCOPANCYISSUED