HomeMy WebLinkAboutF2022-0281 - Permits0PfOJw �, City of Newport Beach -Building Division *F2022-0281* FIRE Permit: F2022-0281
ice` d 100 Civic Center Drive, Newport Beach, CA 92660
': v Permit Counter Phone (949)644-3288
BCt NO : 1033-2022
U:
"ctr,oua Inspection Requests Phone (949)644-3255
Job Address: 333 HOLMWOOD DR NB
Description: SFR FIRE SPRINKLERS (X2019-0547) ADD 12 ADDL HEADS
5��'*�
Inspector Area: 3
Legal
Description:
N TR 1136 LOT 15
Owner: ATKINS JEFFERY S
Contractor:
FIREPROOF FIRE PROTECTION
Architect:
4P
Address: 333 HOLMWOOD DR
Address:
1101 KINGSTON DR
Address:u,:`.
NEWPORT BEACH, CA 92663
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:
0413012024
Address:
LA HABRA CA 90631
Bus Lic:
BT30040107
° ° ° °
Phone:
Lic Exp Date:
07/31/2022
Phone: State Lic
......
"1 ° °°
a a
Code Edit: 2019
Worker's
Compensation
Insurance
Designer: CASEY MONTY
• ' •
°
Type of Construction: V-B-SPR
Carrier:
SECURITY NATIONAL INS
Address: 1101 KINGSTON DR
Occupancy Group: R31U
Policy No:
SWC1373756
LA HABRA CA 90631
Added /New sq.ft. Bldg: 0
Expire:
02115/2023
Phone:
......
° °,
Added/New sq. ft. Garage: 0
....
° .••
No of Stories: - 3
Issued
Date: 06IO2/2022
Special Conditions:
o °
..
No of Units : 0
Setback- Front:
°
, °. •
° ° • °
® °
Floodone:
Rear:
,
.°°.
Bldg Sprinklers: Y
Left:
Right:
°cede.
Construction Valuation: $1,500.00
FEES
Y
•
°°°'
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee :
$0.00
Records Management:
$8.00
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 Fee :
$269.00
TOTAL FEE :
$325.50
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$325.50
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
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 (_) all of or U 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 3mployees' 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-Builderwill have the burden of proving that it was not built or
improved 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
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contracto{ pursuant to the Contractors' State License Law).
❑ 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 one year prior to completion of the improvements covered by this permit, I cannot legall)
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I ur)derstand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.legil{fo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Division 3 of the Business and Professions Code, and my license is in full force
and effect. *.... / °,
LiC,E gpp.lass . _ _ License No D G 1 � 1 1- Contractor Signature ��
WbRKERS' C(3MpBNSATION DECLARATION
WARNWG r.AILURE TO rECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST Or COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I herebyc rm unde r'.malty of perjury one of the following declarations:
IJ I WE and wil:majpjain 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 the
pAtfbMl3rlce of tIR v4c?rk:or which this permit is issued. Policy No.
rave 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' compensatiol
in an& carrier aDd p&y number are:
Carrier Policy Number Expiration Date
I certify that, in 61 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 agre
that, if I should become su/Nett t0
00-the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwithh comply with those provision .
Signature of Applicant / � / 1_-_ Date,., /? (1 1,
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
1 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).
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 (B'enter the above -identified property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name +�. C� r • ate G I y-
ACTION
DATE
BY
DECLARATfONOF COMPLIANCE MTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OF T17LE40 AND
AOMDROLE1403.
PERMIT EXPIRED
❑ I SUBMITTEDASBESTOS W NFICATtON TO:
❑ EPA
❑ AOMD
PERMIT CANCELLED
PERMIT€XTENOED
❑ ASBESTOS N071FICA DON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERNIITFINAL
'Z,q-Z'j
cERTIFICAT€OF
SIGNATURE:
OCCUPANCYISSUED