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Home My WebLink AboutF2022-0155 - Permits (2)"e� City of Newport Beach - Building Division IIIII�IIIIII�IIIIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2022-0155 ti" d 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 1 5 5 u p Project No : 2628-2021 �. � ,,, n Permit Counter Phone (949)644-3288 Y"'e+aor.g Inspection Requests Phone (949)644-3255 Job Address: 2621 ALTA VIS7A DR NB Description: DELTA 1 - CHANGE FIRE RISER LOCATION & ADD 15 HEADS Inspector Area: 4 Legal Description: N TR 4893 LOT 111 Owner: CNQST LLC Contractor: KELLY FIRE PROT INC Architect: Address: 2621 ALTA VISTA DR Address: 10141 THESEUS DR Address: NEWPORT BEACH, CA 92660 HUNTINGTON BCH CA 92646 Phone: Phone: 714-907-7586 Phone: State Lic: Applicant: KELLY SEAN Con State Lic: 878823 Engineer: Address: 10141 THESEUS DR Lic Expire: 0813112023 Address: HUNTINGTON BEACH CA 92646 Bus Lic: BT30070761 Phone: 714.907-7586 Lic Exp Date: 0113112023 Phone: State Lic: Code Edit: 2019 Workers Compensation Insurance Designer: Type of Construction: V-B-SPR Carrier: AMERICAN FAM HOM INS Address: Occupancy Group: R3/U Policy No: 2EA5WC000024603 Added /New sq.ft. Bldg: 0 Expire: 04/11/2022 Phone: Added /New sq. ft. Garage: 0 �-_ No of Stories: 2 Issued Date: 03/2312022 Special Conditions: No of Units : 0 Setback- Front: >� Flood Zone: Rear, .� �� " iri Bldg Sprinklers: Y Left: ~ " Right: FEES Construction Valuation: $2,000.00 Building PC Fee: $0.00 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 as : $0.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $269.00 TOTAL FEE : $273.00 Plan Check Fee : $273.00 Fee Due at Permit Issuance : $0.00 PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL:Ji OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 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 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 licensum 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). I, 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, lusiness 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). I 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 legall 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:hftp://www.leginfo.ca.govlcalaw.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, and my license is in full force nd effect. 7 icense Class License No Dat ? "i 3 Contractor Signatur ur PORKERS' COMPENSATION DECLARATION _/ IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND S® RS ($100,000), IN ADDITION TO THE DST 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 ;ormance 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: Policy Number Expiration Date ie of Agent certify that, in the performance of the work for which this I , if I should become subject to the work rs' compensation / Iature of Applicant /, work - issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I hereby affirm under penalty of perjury tKat there is a consfiLctierflending 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 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 building construction. I authorize representatives of this city or county to ent the above --identified property for inspection purposes. Siqnature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date ACTION DATE RY - DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 81 OF T17LE40AND AQMD RULE 4403. PERMIT EXPIRED ❑ I SUBMITTEDASBESTOS NOTIFICATION TO. ❑ EPA ❑ AQMD PERMfT CANCELLED PERIATEXTENDED ❑ ASBESTOS N077RCA7iONISNOT APPLICABLE TO PROPOSEDDEMOLITION. PERMIT FINAL CERTIFICATE OF SIGNATURE. OCCUPANCYISSUED