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Home My WebLink AboutF2021-0484 - PermitsCity of Newport Beach - Building Division *F2021-0484* FIRE Permit: F2021-0484 as 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 2401-2021 y. Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 °Laras4�' - -:Description: SFR FIRE SPRINKLERS (12) HEADS (X2020-2643) Job Address: 411 IRVINE AVE NB Inspector Area: 3 Legal Description: FIRST ADD TO NEWPORT HEIGHTS ELK 29 LOT 22 • Owner: MANAVI BEHNAM S Contractor: KELLY FIRE PROT INC Architect: ...... ° ° ° • ° . Address: 411 IRVINE AVE Address: 10141 THESEUS DR Address: °°°° NEWPORT BEACH, CA 92663 HUNTINGTON BCH CA 92646 State Lic: Phone: Phone: 714-907-7586 Phone: 0°°•0• •° °• Applicant: KELLY SHAWN / KELLY FIRE PROT INC Con State Lic: 878823 Engineer: •, Address: 10141 THESEUS DR Lic Expire: 08/3112023 Address: o°, 0°„ HUNTINGTON BCH CA 92646 Bus Lic: BT30070761 Phone: State Lic: Phone: 714-907-7586 Lic Exp Date: 01 /31/2022 o aoeo• Code Edit: 2019 Worker's Compensation Insurance Designer: KELLY FIRE PROTECTION INC :', ° • • °° ; ° °, Type of Construction: V-B-SPR Carrier: AMERICAN FAM HOM INS Address: 10141 THESUS DR HUNTINGTON BEACH, CA 9264q... ®° ,,,,,, •, Occupancy Group: R3/U Policy No: 2EA5WC000024603 Phone: 714-704-9024 ° ®° Added /New sq.ft. Bldg: 0 Expire: 0411112022 Added INew sq. ft. Garage: 0 Special Conditions: NOT AN ADU No of Stories: 2 Issued Date: No of Units : 0 Setback- Front: Flood Zone: X Rear: Bldg Sprinklers: Y Left: Right: FEES n Valuation: $3,000.00 Fee : FF[Bui[dingExtention $222.00 Fire Residential Alarm PC Fee: $0.00 Records Management: $2.00 vertime PC Fee: $0.00 Planning Counter Review: $0.00 xtention Fee : $0.00 Planning Zoning PC Fee : $0.00vestigation $0.00 Fee : heck Fee: $0.00 $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 : $493.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $493.00 PROCESSED BY: 6-S OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: 1 1 APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -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 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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L Business and Professions Code: The Contractors' State License Law does not apply to an owner ) all of or (� portions of the work, and the structure is not intended or offered for sale (Section 7044, of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or 5proved for the purpose of sale). I, as ownebeftlaa property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply tq an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). i am exempt from Hcensure under the Contractors' State License Law for the following reason: 3y my signatureb$% 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, ae* 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 Drofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. 31gnafgfe of Prbpe'rry dwner or Authorized Agent Date _ICENSED CQNTBACTOR'S DECLARATION tIerttI4 affirm Lpcj& penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of pivision 3 of the Business and Professions Code, and m license is in full force :IpI gS%Class License No Date Of •'2 Contractor Signature V6R4RS' GONIPENSATION DECLARATIONtK 1414411 y FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U :0 ST�OF COMPEN2frrjo�N, QAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. P TO ONE HONORED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE 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, erformance of the work for which this permit is issued. Policy No. 3 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' compensatior Isurance carrier and policy number are: IS of Agent certify that, in the performance of the work if I should become subject to -the workers: .nature of Applicant f Policy Number I Expiration Date 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 ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. CLARATION REGARDINGOONST ION DING AGENCY sreby affirm under penalty of perjury at there is a nstmction lending agency for the performance of the work for which Ider's Name Lenders Address permit is issued (Section 3097, Civil Code). 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 t enter a above-i tified property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent'. ACTION DATE BY OECLARATfONOFCOMPLIANCEMTH706EOF FEDERAL REGULATIONSPART 61 OF TITLE 40 AND PERMITEXPdRED A6IMORULE 1403, CANCELLED ❑ I SUBMtTTEDASBESTOS N07tFICATIONTO:13 EPA LKTENDED ❑ AOMD FINAL 4b-Z7 k�O ASBESTOS NOTIRCATIONISNOT APPLICABLE TO wwM /' nonnncr.. rxr .....r. — OCCUPANCYISSUED �T '�a4�r I SIGNATURE: