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Home My WebLink AboutF2020-0410 - Permits�$wrov City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 a s �LIi,iYT'\ Job Address: 1821 SABRINA TER NB Inspector Area: 5 Owner: BOMHOF STACY Address: 1821 SABRINA TER CORONA DEL MAR, CA 92625 Phone: Applicant: CASEY MONTY Address: 1101 KINGSTON DR LA HABRA CA 90931 Phone: 714-176-5370 Code Edit : 2019 Type of Construction: V-B-SPR Occupancy Group: R31U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 3 No of Units: 0 Flood Zone: X Bldg Sprinklers: Y FIRE Permit F2020-0410 Project No: 1142-2020 Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLERS 10 HEADS *ADDITIONAL SCOPE* (X2019-1086) Legal Description: N TR 2813 LOT 114 -. 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: 04/3012022 Address: Bus Lic: BT30040107 - - Lic Exp Date: 0813112021 Phone: State Lic. " Worker's Compensation Insurance Designer: CASEY MONTY Carrier: NORGUARD INS CO Address: 1101 KINGSTON DR Policy No: MOWC148394 LA HABRA CA 90631 Expire: 02/1512021 Phone: 714-476-5370 Issued Date: 10113/2020 Special Conditions: REV20-1564 Setback- Front: Rear: Left: Right: FEES Construction Valuation: $1,000.00 Building PC Fee : $217.00 Fire Residential Alarm PC Fee: $0.00 Records Management: $4.00 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 : $263.00 TOTAL FEE : $484.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $484.00 -1 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: \. 1 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 t0 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 (_) 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 legally sell a Jtructure tha( . ;lave 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 Prof)rslons Code, is available upon request when this application is submitted or at the following Web site:http://weWv.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CON (RACTOR'S DECLARATION I hereby affix, under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se ion 7000) of Division 3 of the Business and Pr Ifessions Code, and my license is in full force and effect. License Class License No Date I)j. 3Contractor Signature WORKERS' COMPENSATION 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 HUNDRS THOUSAND DOLLARS (EJUe,ODOI, IN ADDITION TO THE CJJ: OF COMPENSATIOir, DAMAGES AS PROVIDED FOR IN SECTION 3TO6 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. ,ia.eby affirm under penalty of perjury one of the following declarations: 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 'ormance 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 number are: Policy Number Ie of Agent Phone; certify that, in the pert rmance of the work for which this permit is issued, I shall not employ any person in any manner so as to become sL 0.e if I should becorsbject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Date to the workers' compensation laws of California, and Signature of Applican v V Date DECLARATION REG O DING NSTRUCTION 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 cou7ty ordinances and state laws relating to building construction. I authorize representatives of this city or cou e r the above-identifiedroperty for inspection purposes. N n /- Signature of Property Owner or Authorized Agent �'r Print Property Owner's or Authorized Agent's Name I /� M •+. iw. J I L�ite a 3 1 ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOROFACEUSEON FEDERAL REGULATIONS PART fit OF TITLE 40AND AQMO RULE 1403. PERMfT EXPIRED ❑ I SUBMITTEDASBESTOS NOAFICATION TO: ❑ EPA ❑ AQMD PERMITCANCEUED PERMITEXTENDED ❑ ASBESTOS M017RCAT70NIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITFINAL D r CERTIFfCATEOF SIGNATURE: OCCUPANCYISSUED