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Home My WebLink AboutF2021-0407 - Permits0stxr City of Newport Beach - Building Division ��8�� FIRE Permit: F2O21-0407 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 2127-2021 Permit Counter Phone (949)644-3288 fiaGzr+uu+'�' Inspection Requests Phone (949)644-3255 Job Address: 424 RIVERA TER NB Description: FIRE SPRINKLERS FOR NEW SFR (45) HEADS X2019-3242 Inspector Area: 5 Legal Description: TR 1237 LOT 155 POR OF LOT(AND POR OF LOT 156 Owner: DOLOTTA PETER/SUH SUNG-HEE Contractor: FIREPROOF FIRE PROTECTION Architect: Address: 231 DRIFTWOOD RD Address: 1101 KINGSTON DR Address: CDM CA 92625 LA HABRA CA 90631 Phone: Phone: 714-476-5370 Phone: State Lic: Applicant: CASEY MONTY Con State Lic: 876004 Engineer: Address: 1101 KINGSTON DR Lic Expire: 04/30/2022 Address: LA HABRA CA 90631 Bus Lic: BT30040107 Phone: 7141476-5370 Lic Exp Date: 07/31/2022 Phone: State Lic: °— Z Code Edit: 2019 Workers Compensation Insurance Designer: CASEY MONTY Type of Construction: V-BSPR Carrier: SECURITY NATIONAL INS Address: 1101 KINGSTON DR Occupancy Group: R3/U Policy No: SWC1325710 LA HABRA CA 90631 Added/New sq.ft. Bldg: 0 Expire: 02/15/2022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 3 Issued Date: 09/1512021 Special Conditions: o � , ° • No of Units: 0 Setback -Front: °,, ,,° • °°x„ Flood Zone: Rear: Bldg Sprinklers: Y Left: Right:, ° FEES• Construction Valuation: $4,500.00 Building PC Fee: $222.00 Fire Residential Alarm PC Fee : $0.00 Records Management : $6.00 Building Overtime PC Fee: $0.00 Planning Counter Review : $0.00 Building Extertion 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: $269.00 TOTAL FEE : $497.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $497.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: t' r'1) PLAN CHECKED BY:: �f FIRE APPROVAL: APPROVAL TO ISSUE: /� PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 U all of or 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). LJ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70, apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra( ❑ 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 or sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.le Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm Vglpr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700C and effect. License Class • • • • License No Date l • I, r WUAkERS'C0*A11'ENSATION DECLARATION IaARNWNG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEI ,COST 0' COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. it hereby affirm•LgiVgr•Ijenalty of perjury one of the following declarations: k:;a,rri7e,a. ve and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director ance ottns wo6k forwhich this permit is issued. Policy No. e and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the ce carrierandpolicy number are: • _ Policy Number ii"Agent b$ify that, m the pi if I should become the work for which this permit is issued, I shall not employ any person in any workers' compensation provisions of Section 3700 of the Labor Code, I shall Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year prior to completion of the improvements covered by this permit, I cannot nderstand that a copy of the applicable law, Section 7044 of the Business and Date Division 3 of the Business and Professions Code, and my license is in full force Contractor Signature AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO Industrial Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date so as to become subject to the workers' compensation laws of California, and h comply with those provision Signature of Applicant fr • `- I Date / L "I f I / 1 f DECLARATION REGAKIDING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty 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). Lenders 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 enter the above -identified property for inspection purposes. Signature of Property Owner or Authorized Age e' _ Print Property Owner's or Authorized Agent's Name %A 1, Date is.Kr ACTION I DATE I BY I PERMIT EXPIRED I I I I PERMIT CANCELLED I I I / / I PERMITFINAL CERTIFICATEOF OCCUPANCYISSUEO FEDERAL. REGULATIONSPART 61 OF T17LE40 AND AQMD RULE 1403, ❑ I SUBMITTED ASBESTOS NOTIFICATION' TO:. ❑ EPA ❑ AQMD' °Q ASBESTOS NOTIFICATION IS NOT APPLICABLE TO SIGNATURE: FOR OFFICE USE ONLY