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HomeMy WebLinkAboutF2020-0266 - Permits (3)City of Newport Beach - Building Division II�IIIIIIII�IIIIIIIIIIIUIII�IIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 2418 HOLLY LN NB Inspector Area: 3 Owner: DAVIES TOM & JANELLE Address: 2418 HOLLY LN NEWPORT BEACH, CA 92663 Phone: 347-971-1018 Applicant: CASEY MONTY Address: 1101 KINGTON DR LA HBRA CA 90631 Phone: 714-476.5370 Code Edit: 2019 Type of Construction: V-B-SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Flood Zone: X Bldg Sprinklers: Y FIRE Permit: F2020-0266 Project No: 1085-2020 Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLERS (34 HEADS) X20193463 Legal Description: N TR 1702 LOT 24 Contractor: FIREPROOF FIRE PROTECTION Address: 1101 KINGSTON DR LA HABRA CA 90631 Phone: 714-476-5370 Con State Lie: 876004 Lie Expire: 04/30/2022 Bus Lie: BT30040107 Lie Exp Date: 08/31/2021 Worker's Compensation Insurance Carrier: SECURITY NATIONAL INS Policy No: SWC1325710 -Expire: 0211612022 Issued Date: 07102/2020 Setback- Front: Rear: Left: Right: Architect: Address: Phone: State Lie Engineer: Address: Phone: State Lie: Designer: CASEY MONTY Address: 1101 KINGSTON DR LA HABRA CA 90631 =. Phone: 714-476-5370 Special Conditions: 2 I8121 r% toneo�fia s 0 FEES Construction Valuation: $3,000.00 Building PC Fee : $202.00 Fire Residential Alarm PC Fee : $0.00 Records Management : $6.00 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: $240.00 TOTAL FEE : $448.00 Plan Check Fee: $448.00 Fee Due at Permit Issuance : $0.00 PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: OTHER DEPARTMENT? PLAN CHECKED APPROVAL TO ISSUE: co • ° ° ae• 00 0 0 0 o a o PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALIDGIINSPECtic'M p0 p00 0 0 BB ®0° riJO DECLARATION 1 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) ction 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 Cessions 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 more than five hundred dollars ($500). J 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions iusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of c, nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7C pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra I am exempt from Iicensure 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 o ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 'rofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.11 .ignature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 nd effect. icense Class License No Date COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: 7 I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Dire erformance of the work 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 isurance carrier and policy number are: :amier Policy Number lame of Agent the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the 3letion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). e year prior to completion of the improvements covered by this permit, I cannot understand that a copy of the applicable law, Section 7044 of the Business and Date of 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 ($100,000(, IN ADDITION TO THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date 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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Date DECLARATION REGARDING CONSTRUCTION LENDING AGENCY 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). 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 building construction. 1 authorize representatives of this city or county to enter the above -identified property for inspection purposes. ignature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name ACTION BAN BY DECLARATION OF COMPLIANCE MTH CODE OF FOR OFFICE USE ONLY • • • • • FEDERAL R€GULATIONSPART 6?OF TIR€40AND AQMD RULE 1403 ••• PERMITEXP/REO , „� , ❑ ISUBMITFEDASSESTOSAfOI7FICATIONTO: ❑ EPA ❑ AQMD PERMIT CANCELLED ' • °•° '; P€RMITIXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSEDDEMOLITION PERMIT FINAL • •„ „ CERTIFICATEOF ° ° ° ° e SIGNATURE: OCCUPANCYISSUED • e • • ° • e e e