HomeMy WebLinkAboutF2021-0303 - Permitsr�s City of Newport Beach - Building Division *F2021-0303* FIRE Permit: F2021-0303
e 100 Civic Center Drive, Newport Beach, CA 92660
s P Project No: 1642-2021
.W �" a- p'- %^ Permit Counter Phone (949)644-3286
gartrna .. Inspection Requests Phone (949)644-3255
Job Address: 1940 TERESITA LN NB
Description: SFR FIRE SPRINKLERS 36 HEADS (X2019-3625)
Inspector Area: 3
Legal Description:
N TR 1806 LOT 49
Owner: CONN ROBERT & PT
Contractor:
ALL AMERICAN FIRE SYSTEMS Architect:
Address: 1940 TERESITA LN
Address:
PO BOX 2306 Address:
ft
NEWPORT BEACH, CA 92660
MISSION VIEJO, CA 92690
Phone:
Phone:
714-476-3169 Phone: State Lic:
Applicant: MCSTAY MIKE
Con State Lic:
1034609 Engineer:
Address: 27068 LA PAZ RD @212
Lic Expire:
01/3112022 Address:
,
ALISO VIEJO, CA 92659
Bus Lic:
BT30072047
Phone: 949-337-33317
Lic Exp Date:
06/30/2022 Phone: State Lic:
e
°:
Code Edit: 2019
Worker's Compensation
Insurance Designer:
Type of Construction: V-B-SPR
Carrier:
WESTCHESTER FIRE INS Address:
Occupancy Group: R3/U
Policy No:
71827709
°
Added /New sq.ft. Bldg: 0
Expire:
11122/2021 Phone:
Added /New sq. ft. Garage: 0
„®
No of Stories: 2
Issued Date: 0712212021 Special Conditions:
•°• °
No of Units : 1
Setback- Front:
Flood Zone: X
Rear:
°
Bldg Sprinklers: Y
Left:
Right:
0
FEES
°
Construction Valuation: $6,500.00
Building PC Fee :
$0.00
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:
$260.25
Public Works PC Fee : $0.00
$0.00
Fire Permit Fee :
$360.00
Public Works Traffic Plan Check Fee; $0.00
Building Permit Fee:
$0.00
TOTAL FEE :
$6616.25
Plan Check Fee: $616.25 Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
v
OTHER DEPARTMENT:
ZONING APPROVAL:
PLAN CHECKED BY::
FIRE APPROVAL: df
APPROVAL TO ISSUE: t
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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fNER-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)
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
fessions 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 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of
lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of coff
nproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrach
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
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I u
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.legi
signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm unrrerpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)
nd effect. • •'
�ieense Class• • • • License No Date `t- 2
1 ORIZERS' VOMPENSATION DECLARATION
IARNINS: FAILURE 1.0 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA
OSi t)F COMPENSATION/DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ilgreby affirm udder penalty of perjury one of the following declarations
certificate of consent to self -insure for workers' compensation, issued by the Director
ch this permit is issued. Policy No.
mill maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the
carni r%V'Mllcy number are:
'• Policy Number
certify that, in the performance of
if I should become subjec e
latureofApplic <
issued, I shall not employ any person in any
ns of Section 3700 of the Labor Code, I shall
work, and the structure is not intended or offered for sale (Section 7044,
oloyees' or personal effort, builds or improves the property, provided that the
on, 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).
that a copy of the applicable law, Section 7044 of the Business and
Date
Division 3 of the Business and Professions Cod y licenag is in full force
Contractor Signature
TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE
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
i comply with those provisions.
I hereby affirm under penalty of perjury that there is a construction en ncy 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. —7
I authorize representatives of this city or coun er ove-identified property for inspection purposes.
Signature of Property Owner or Authorized AgI Print Property Owner's or Authorized Agent's Name �/ �• / ! `_` Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE IMTN CODE OF
F FICE USE ONLY
FEDERAL REGULA TIONS PART BI OF 1711,E40 AND
AQMDRULE 1403.
PERMITEXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:.
❑ EPA,
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS MORRCAATIONISNOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
CERTIFICATE OF
SIGNATURE:
OCCUPANCYISSUED