HomeMy WebLinkAboutf2020-0094 - Permits$1T City of Newport Beach - Building Division IIIII�IIIII�IIIIIIIIIIII�IIIIIIIIII� II
FIRE Permit: F2020-0094
e 100 Civic Center Drive, Newport
s
Beach, CA 92660
F 2 0 2 0 0 0 9 a
Project No: 0402-2020
Permit Counter Phone (949)644.3288
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Inspection Requests Phone (949)644-3255
Job Address: 1027 DOLPHIN TER NB
Description: SFR FIRE SPRINKLERS 52 HEADS (X2018-3166)
Inspector Area: 2
Legal Description:
N TR 5130 LOT 7
Owner: MEYER HOLDINGS LLC
Contractor:
FIREPROOF FIRE PROTECTION Architect:
P gay
Address: 4320 VON KARMAN AVE
Address:
1101 KINGSTON DR Address:
i
NEWPORT BEACH CA 92660
LA HABRA CA 90631°°''
Phone:
Phone:
714-476-5370 Phone:
State Lie:
Applicant: FIREPROOF FIRE PROTECTION
Con State Lie:
876004 Engineer:
l a
Address: 1101 KINGSTON DR
Lie Expire:
04130/2020 Address:
LA HABRA CA 90631
Bus Lie:
BT30040107
Phone: 714-476-5370
Code
Lie Exp Date:
0713112020 Phone:
State Lic:
0
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: R31U
Policy No:
MOWC148394
LA HABRA, CA 90631
Added /New sq.ft. Bldg: 0
Expire:
02115/2021 Phone:
714-476-5370
Added /New sq. ft. Garage: 0
No of Stories: 1
Issued Date: 02/2612020 Special Conditions:
LANDSLIDE AREA
No of Units: 0
Setback- Front:
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
Right:
FEES
Construction Valuation: $5,200.00
Building PC Fee,
$202.00
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 Fee :
$240.00
TOTAL FEE :
$446.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance :
$446.00
PROCESSED BY:
..7.TH EIZPEPARTM ENT:
ZONING APPROVAL:
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FIRE APPROVAL :
APPROVAL TO ISSUE:
0
PERMIT EXPIRES 180 DAY!' AFTER�SDUANCEd3R° LAST VALID INSPECTION
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IWNER-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 nextto 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
ie 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
'rofessions 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
of more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
�usiness 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
nprovements 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
nproved 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
pply 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:
ly 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
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/mlaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
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 Professions Code aitd-my4i nse Is in full force
nd effect.
.icense Class License No Date �-� Contractor Signature�--=�
VORKERS' COMPENSATION DECLARATION
rARNING: FAILURE TO SECURE WORKER;' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ( , NADDITION TO THE
'.OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'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
erf mance of the work for which this permit is issued. Policy No.
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' compensatiol
rsurance carrier an oS10 by number are:
Date
of Agent
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 su*ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prpipions.
of Applicant
M
hereby affirm under Analty of perjury that there is a cc st tion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ender's Name Lender's Address
y 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 county ordinances and state laws relating to builds construction.
I authorize representatives of this city or county{o ejer/the-ebove-identified property for inspection purposes.
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