HomeMy WebLinkAboutF2021-0005 - Permits0$w „� City of Newport Beach -Building Division *F2021-0005* FIRE Permit: F2021-0005
A 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0031-2021
-$ v Permit Counter Phone (949)644-3288
rizr<�u+'�a Inspection Requests Phone (949)644-3255
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Job Address: 500 NEWPORT CENTER DR NB St: 1 FI: 8 Description: COMM FIRE ALARM (2 DEVICES) X2021-0029
Inspector Area: FIRE
Legal Description:
IRVINE SUB LOT BILK 93 POR OF BILK
Owner: TINGLER DAVID S
Contractor:
SIMPSON DAVID CONST CO INC
Architect:
f��� Ir-1
Address: 500 NEWPORT CENTER DR
Address:
17177 GILLETTE AVE #A
Address:
Yell
NEWPORT BEACH, CA 92660
IRVINE CA 92614
Phone:
Phone:
949-250-1348
Phone:
State Lie:
Applicant: MORFORD PAUL
Con State Lie:
381149
Engineer:
Address: 4675 MACARTHUR CT #100
Lie Expire:
03/3112021
Address:-
NEWPORT BEACH CA 92660
Bus Lie:
BT00006013
-
Phone: 949-863-9434
Lie Exp Date:
0613012021
Phone:
State Lie:
Code Edit : 2019
Worker's Compensation
Insurance
Designer:
TAYLOR RICK
Type of Construction: I-A-SPR
Carrier:
OAK RIVER
Address:
2246 LINDSAY WAY ......
Occupancy Group: B
Policy No:
DAWC015550
GLENDORA CA 91740
Added /New sq.ft. Bldg: 0
Expire:
0610112021
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 9
Issued Date: 03117/2021
Special Conditions:
No of Units: 0
Setback- Front:
Flood Zone:
Rear:
-
Bldg Sprinklers: Y
Left:
Right:
FEES
Construction Valuation: $1,127.00
Building PC Fee:
$0.00
Fire Residential Alarm PC Fee:
$0.00
Records Management : $0.00
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:
$164.50
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee :
$234.50
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTAL FEE :
$399.00
Plan Check Fee :
$164.50 Fee Due at Permit Issuance : $234.50
PROCESSED BY:
OTHER DEPARTMENT:
ZONING APPROVAL:
PLAN CHECKED BY::
FIRE APPROVAL:
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
1e 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 Iicensure 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) 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
n roved 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
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 Iicensure under the Contractors' State License Law for the following reason:
,y 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 Iega11,
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 following Web site:http://wowd.leginfo.ca.gov/calaw.htmi.
ignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
herehy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (comm nci with S Ion 7000) of Division 3 of Business and Pro sions Code, nd my is se is in full force
I ,d effec:. "
iconse Class License No a I J Cont a o igna[ure ^ 1
6ORXERS' COMPENSATION DECLARATION
AIMING. FAILURE 77 ,FCVRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10D,000), IN ADDITION TO THE
0S1 OF COMPENSATION, D-MAGES AS PROVIDED FOR IN SECTION 3T06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hPrahy affirm w,der ps;,alty of perjury one of the following declarations:
L r-ve 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
Wince of the work for which this permit is issued. Policy No.
W;l me intain 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'
ier and policy number are:
Policy Number
s of Agent
ertify that, in the pe an f the work fq� which i permit is issued, I shall not employ any person in any manner so as to
if I should beco subject the workers' %mpen on provisions of Section 3700 of the Labor Code, I shall forthwith compy
Date
subject to the workers' compensation laws of California, and
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this per it' sued (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 or /(lances a� stat �ws relating to building construction.
I authorize representatives of this city or county to an fthe abol Ide led property for inspection purposes. 1
Signature of Property Owner c uth d Agent L'0f Print Property Owner's or Auth ed Agent's Name �7 t/1, �/ / ' A✓) t fr P
AC77ON
DATE
BY
DECLARATION OF COMPLIANCE MM CODE OF
FOR OFFICE USE N
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
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PERMfT EXPIRED
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PERMIT UTENDED
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PERMIT FINAL
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SIGNAT