HomeMy WebLinkAboutF2021-0159 - Permits (3)0"'' City of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII II FIRE Permit: F2021-0159
.i 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 1 5 9 Project No : 0934-2021
�, r Permit Counter Phone (949)644-3288
e't+rrx �`� 0 Inspection Requests Phone (949)644-3255
Job Address: 506 CLUBHOUSE AVE NB 1114-- Description: SFR FIRE SPRINKLERS (45) HEADS (X2019-1552)
Inspector Area: 1
Owner: GARG SUSHIL
Address: 27621 HIDDEN TRAIL RD
LAGUNA HILLS CA 92653
Phone: 949-567-7035
Applicant:
INNES ELIZABETH
Address:
9521 IRVINE CENTER DR
IRVINE CA 92618
Phone:
949-861-2244
Code Edit : 2019
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
V-B-SPR
R3/U
0
0
Legal Description: CANAL
Contractor: FIREPR9
Address: 1101 KING
O—LA HABRA
Phone: �P14-476-53T
Con State Lie:
0 04
Lie Expire:
022
011
Bus Li
BT 107
Lie Exp Date:
07/31
Worker's Compensation
In
Carrier:
SECURI
Policy No:
SWC132571
Expire: 02/1512022
0 Issued Date: 09/30/2021
0 Setback- Front:
X Rear:
Y Left:
Right:
LOT 1 BILK 532 ALL -INC POR OF ST ADJON S-
E PROTECTION Architect:
OR Address:
Phone:
Engineer:
Address:
2
Phone:
INSO.n
V�
Designer:
Address:
Phone:
Special Conditions:
State Lie:
State Lie,
CASEY MONTY --
1101 KINGSTON DR
LA HABRA CA 90631
714-476-5370
LIQUI3-FAGr0l,
FEES
Construction Valuation:
$4,500.00
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:
$285.00
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$379.25
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$670.25
Plan Check Fee :
$281.00 Fee Due at Permit Issuance :
$389.25
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
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APPROVAL TO ISSUE: m o V
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PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LASb Vs9LIGkVS0?CCTI®N U o
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JWNER-BUILDER DECLARATION
I hereby affirm under penalty of perju 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 Profess ns 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
he permit to file a signed statement kKt 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 xempt 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
J I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions
lusiness 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).
1 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 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 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:http://www.1(
signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
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
)letion, 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).
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
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7009) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. [' �%
icense Class License No Date i Contractor Signaturre/y
PORKERS' COMPENSATION DECLARATION
DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations: -
Irmance of the work for which this permit is issued. Policy No. have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Directo of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
efo
and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for thel, performance of the work for which this permit is issued. My workers'
carrier and policy number are:
Policy Number
of Agent
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall
of
Date
so as to become subject to the workers' compensation laws of California, and
1 comply with those` provisions`
Datee
DECLARATION REGARDMOG 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).
Lender's Name Lender's Address
By my signature below, 1 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 to enter the above -identified property for inspection purposes. p
Signature of Property Owner or Authorized Agent 'A J*� Print Property Owner's or authorized Agent's Name /I/ I" L•." i•-r ••v Date
ACTION
DATE V
BY
DECLARATION OF COMPLIANCE l4RTN CODE OF
VFOR OFFICE U5EONLY
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..FEDERAL REGULATIONS PART 51 OF TITLE 40 AND
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