HomeMy WebLinkAboutF2021-0602 - Permits"t"z City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
., , 100 Civic Center Drive, Newport Beach, CA 92660 IF2 0 2 1 0 6 0 2
E~ v Permit Counter Phone (949)644-3288
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Job Address: 324 L ST NB Description: SFR FIRE SPRINKLERS ()
Inspector Area: 1 Legal Description: N TR 518 BLK M LOT 11
Owner:
RUPPERT CHRISTY
Contractor:
BM PLUMBING AND FIRE PROTECTION INC
Address:
324 L ST
Address:
13923 S CRENSHAW BLVD
NEWPORT BEACH, CA 92661
HAWTHORNE CA 90250
Phone:
Phone:
310-355-1111
Applicant:
LOPEZ ANGELICA
Con State Lic:
952941
Address:
13923 S CRENSHAW BLVD
Lic Expire:
09130/2022
HAWTHORNE CA 90250
Bus Lic:
BT30077349
Phone:
310-773-6248
Lic Exp Date:
11/3012022
Code Edit: 2019
Worker's Compensation Insurance
Type of Construction:
V-B-SPR
Carrier:
SECURITY NAT'L INS CO
Occupancy Group:
R3/U
Policy No:
SWC1157240
Added /New sq.ft. Bldg:
0
Expire:
07/15/2022
Added /New sq. ft. Garage:
0
No of Stories:
2
Issued Date:
11/3012021
No of Units :
0
Setback- Front:
Flood Zone:
X
Rear:
Bldg Sprinklers:
Y
Left:
Right:
FIRE Permit: F2021-0602
Project No : 2795-2021
Inspection Requests Phone (949)644-3255
1206/X2020.2A433)) r26 HEADS
Antect
AZOss: Q�k
Phone. sG State Lic
Enginea(\
Address:
Phone: �� State Lic
Designer: NHAORNE
ORRE
Address: CRENS BLVD
CA 0
Phone:
Special Conditions:
FEES
Construction Valuation:
$2,500.00
'
Building PC Fee :
$222.00
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:
$0.00
Public Works PC Fee:
o
$0.00
Fire Permit Fee .
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$269.00
TOTAL FEE :
$497.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$497.00
PROCESSED BY: U Y. - OTiER LEPARTMENT:
ZONING APPROVAL: PL.1N CI LCKED BY::
FIRE APPROVAL: �,T APPROVAL TO ISSUE:
PERMIT EXPIRES lee rlAY3 AFTER ISSUANCE Ott LAST VALID INSPECTION
)WNER-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
ie 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
'rofessions 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
of more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved 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
pply to 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).
7 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 year prior to completion of the improvements covered by this permit, I cannot legally
ell 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
'rofessions Code, is available upon request when this application is submitted or at the fallowing Web site:http://www.leginfo.ca.gov/calaw.html.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Saction 7000) of Division 3 of the Business and Professions Code, and in ense is in full force
nd effect.
icense Class License No Date I Contractor Sign re
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
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:
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 thl
e nuance of the work for which this permit is issued. Policy No.
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'
carrier and policy numb r are: �-T �7
�}.G,,� l r M �-C Policy Number �"� L L �.�2.3 IU Expiration Date 7 12-b ( 2
ne of Agent
certify that, in the erforman'a of the work for
if I should I ecom ubject to the workers' co
iature of Applicant
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
I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those ro islons.
(t(ar�121
:reby affirm under penalty of perjury tl at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
rder's Name Lender's Address
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 cour ty ordinances and state laws relating to building construction.
I authorize representatives of this city or county }O enter the atyave-identified propEny for inspection purposes.
of Property Owner or
2
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
vFUEHsiL REGULATIONS PAA7 GI bF'OTLE40AND
AOMD PULE 1403..
PERMIT EXPMED
r' I FI rBMtTTEU 4S,3E5TOS NORFII:ATtON TO:
❑ EPA -
❑ AOMD
PERMIT CANCELLED
PERMITEXFENDED
❑ ASBESTOS NOTIFICA710N IS NOT APPLICABLE TO
PROP, )SED DEM01 ITION
_
PERMIT FINAL
CERTIFICATEOF
SIGNAPJRE
OCCUPANCYISSUED
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