HomeMy WebLinkAboutF2021-0585 - Permits,N/r.tr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIII II
y„ 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 5 8 5
Permit Counter Phone (949)644-3288
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Job Address: 2001 CENTELLA PL NB
Inspector Area: 3
Owner:
SACKMAN PAUL
Address:
2001 CENTELLA PL
NEWPORT BEACH CA 92660
Phone:
Applicant:
BRIDGES JEFF
Address:
1229 EAST ASH AVE
FULLERTON CA 92831
Phone:
714/578-0900
Code Edit : 2019
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
0
Flood Zone:
Bldg Sprinklers:
Y
FIRE Permit: F2021-0585
Project No : 2743-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS 13D (67 HEADS) X2021-1886
Legal Description: N TR 3379 LOT 1
Contractor:
J B FIRE PROTECTION
Architect:
Address:
1229 E ASH AVE
Address:
FULLERTON CA 92831
Phone:
714-578-0900
Phone: State Lic:
Con State Lic:
647282
Engineer:
Lic Expire:
0313112023
Address:
Bus Lic:
BT30064756
Lic Exp Date:
04/30/2022
Phone: State Lic:
Worker's Compensation Insurance
Designer:
BRIDGES JEFF
Carrier.
STATE FUND
Address:
1229 EAST ASH AVE
Policy No:
1962369
FULLERTON CA 92831
Expire:
03/01/2022
Phone:
Issued Date:
1112312021
Special Conditions:
revised # of heads
Setback- Front:
`,.
12/2121
Rear:
_
`
Left:
Right:
FEES
Construction Valuation:
$5,000.00
Building PC Fee:
$222.00
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 :
$499.00
Plan Check Fee :
$499.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
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 far the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
(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 U 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 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
improved for the purpose of sale).
❑ 1, 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 Contractor 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 understand 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.leginfo.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) of Division 3 of the Business and Professions Code, and my license is in full force
and effect.
License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one Of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as providedfor by Section 3700 of the Labor Code, for thf
,performance of the work for which this permit is issued. Policy No.
131 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
insurance carrier and policy number are:
Policy Number
Date
ie of Agent
certify that, in the 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
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant uace
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
areby 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).
ider'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 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.
[nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OF TITLE40AND
AQMD RULE 1403.
❑ I SUBMITTED -ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PEAMIFEXPfRED
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED