HomeMy WebLinkAboutF2020-0377 - PermitsCity of N,ewp(,$ Beach -Building Division
- 100 Civic Center Drive, 'Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
U � N
Job Address: 850 SAN CLEMENTE DR NB
Inspector Area: FIRE
Owner:
VIVANTE NEWPORT CENTER LLC
Address:
1 MACARTHUR PL #300
SANTA ANA CA 92707
Phone:
Applicant:
WEST COAST FIRE & INTEGRATION
Address:
22405 LA PALMA AVE
YORBA LINDA CA 92887
Phone:
714-957-5750
Code Edit : 2019
Type of Construction:
I-ASPR
Occupancy Group:
R2.11 A2
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
6
No of Units :
0
Flood Zone:
Bldg Sprinklers:
Y
Construction Valuation: $260,000.00
FIRE Permit: F2020-0377
Project No : 1659-2020
Inspection Requests Phone (949)644-3255
(�Evaraa aIsi, IIt�1�3
Description: COMM FIRE ALARM "VIVANTE SENIOR LIVING'
11659-2020
XaC) li q- a -I 2_��
Legal Description: P BK 81 PG 8 PAR 2
Contractor:
WEST COAST FIRE & INTEGRATION
Architect:
Address:
3199-D AIRLOOP DR
Address:
COSTA MESA CA 92626
Phone:
562-665-0883
Phone:
Con State Lic:
989173
Engineer:
Lic Expire:
12/31/2021
Address:
Bus Lic:
BT30050007
Lic Exp Date:
03/31/2021
Phone:
Worker's Compensation
Insurance
Designer:
Carrier:
AFH INS. CO,
Address:
Policy No:
2EA5WC900066601
Expire:
0111512021
Phone:
Issued Date: 1010612020
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
Building PC Fee : $0.00
Building Overtime PC Fee: $0.00
Building Extention Fee : $0.00
Building Investigation Fee : $0.00
Fire Plan Check Fee: $1,667.50
Fire Permit Fee : $2.405.50
Building Permit Fee : $0.00
TOT FEE : $4,123.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL: / J I
FEES
Fire Residential Alarm PC Fee
Planning Counter Review:
Planning Zoning PC Fee
Public Works PC Fee
Public Works Traffic Plan Check Fee;
Plan Check Fee :
INSPECTOR
State Lic: _
State Lic:
$0.00 Records Management
$0.00
$0.00
$0.00
$0.00
$1,667.50 Fee Due at Permit Issuance
OTHER DEPART
PLAN CHECKED
Ia199:Z�17s1+U7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID
$50.00
$0.00
$0.00
$2,455.50
OWNER -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
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).
❑ 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
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).
❑ I 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 Cift, '.E-vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
:LI:.ENSED CUN fRACTOR'S DECLARATION
II hereby affirm undal penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license is in full force
and effect.
License Class License No q&q l 9 =J Date 0 O6 /zO,,o Contractor Signature
WORKERS' CCh7f ENSATION DECLARATION
(WARNING: FAILURE TJ S-CURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
JJl bF COMPENSA,ION, DAMAGES AS PROVIDED FOR rN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I' '1uJSy affirm under penalty of perjury one of the following declarations:
I have and v'ill 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 th
pe ormance of lhp work for which this permit is issued. Policy No.
I ha _- and wi;l i,aintain 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' compensatio
insur ce carrier end policy number are:
ter-A'!vvwLC` rmL��oli�cy Number 2ery5 IN04 J 6CGUI Expiration Date _ V151--o7-1
Name of Agent Phone #
I 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 agre
that, 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 Da�
DECLARATION REGA DING CON RUCTION L IN GENCY
I hereby affirm under p natty of perjury that there is a n It ction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cade).
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 count to ter he above -id i property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name IC-IM lam- D
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITK CODE OF
FOR OFFICE USED Y
FEDERAL REGULATIONS PART 61 OF TI RE 4f1 ANO
AOMD RULE 1403.
PERMIT EXPIRED
1 SUBMITTEDASBESTOS NOUFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS N07IRCA7I0Nl5 NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
i
CERTIFICATE OF
SIGNATURE:
OCCUPANCYISSUED
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