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HomeMy WebLinkAboutF2021-0159 - Permits§ r�$ City of Newport Beach - Building Division 11�111 11111111111111111111111111111111111111111111111 Jill 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 1 5 9 Permit Counter Phone (949)644-3288 Job Address: 506 CLUBHOUSE AVE NB Inspector Area: 1 Owner: GARG SUSHIL Address: 27621 HIDDEN TRAIL RD LAGUNA HILLS CA 92653 Phone: 949-567-7036 Applicant: INNES ELIZABETH Address: 9521 IRVINE CENTER DR IRVINE CA 92618 Phone: 949-861-2244 Code Edit: 2019 Type of Construction: V-BSPR Occupancy Group: R3IU Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Flood Zone: X Bldg Sprinklers: Y Construction Valuation: $4,500.00 Building PC Fee Building Overtime PC Fee: Building Extention Fee, Building Investigation Fee: Fire Plan Check Fee: Fire Permit Fee : Building Permit Fee: TOTALFEE: PROCESSED BY: FIRE APPROVAL: FIRE Permit: F2021-0159 Project No : 0934-2021 Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLERS (56) HEADS (X2019-1552) Legal Description: CANAL SECTION LOT 1 BLK 532 ALL -INC POR OF ST ADJON S- Contractor: FIREPROOF FIRE PROTECTION Architect: Address: 1101 KINGSTON DR Address: LA HABRA CA 90631 Phone: 714-476-5370 Phone: State Lic: Con State Lic: 876004 Engineer: Lic Expire: 04/30/2022 Address: Bus Lic: BT30040107 Lic Exp Date: 07131/2022 Phone: State Lic: Worker's Compensation Insurance Designer: CASEY MONTY Carrier: SECURITY NATIONAL INS Address: 1101 KINGSTON DR Policy No: SWC1325710 LA HABRA CA 90631 Expire: 02/15/2022 Phone: 714-476-5370 Issued Date: 09/30/2021 Special Conditions: LIQUEFACTION AREA Setback- Front: Rear: Left: Right: FEES $0.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $6.00 $0.00 Planning Counter Review: $0.00 $0.00 Planning Zoning PC Fee : $0.00 $0.00 $0.00 $285.00 Public Works PC Fee: $0.00 $0.00 $379.25 Public Works Traffic Plan Check Fee; $0.00 $0.00 $670.25 Plan Check Fee: $670.25 Fee Due at Permit Issuance : $0.00 OTHER DEPARTMENT: 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). 111, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions f 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 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 cmpletion, the Owner -Builder will have the burden of proving that it was not built or I improved for the purpose of sale). LJ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 71 apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contr: ❑ I am exempt from Iicensure 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 c sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.l Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70C and effect. License Class License No Date VORKERS' COMPENSATION DECLARATION rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 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 iderstand that a copy of the applicable law, Section 7044 of the Business and ifo.ca.gov/calaw.html. Date of Division 3 of the Business and Professions Code, and my license is in full force Contractor Signature CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE J 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 erformance of the work for which this permit is issued. Policy No. JI have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for Isurance carrier and policy number are: Policy Number of Agent 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 manrier 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. Signature of Applicant i Date DECLARATION REGARDING 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, 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 to enter the above -identified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date ACTION DATE BY DECLARATION OF COMPLIANCE INITH COOEOF FEDERAL REGULATIONS PART 61. OF TITLE40AND AQMD RULE 1403 ❑ I SUBMITTEDASBEST05 NOTIFICATION T0:'. ❑ EPA ❑ AQMD ❑ ASBESTOS NOTfRCARONISNOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: FOR OFNCEUSEONLY PERMIT EXPIRED PERMIT CANCELLED PERMITEXTENDED PERMITFINAL Z L c) CERTIFICATE OF OCCUPANCYISSUED