HomeMy WebLinkAboutF2022-0128 - PermitsCity of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 1 2 8
w Permit Counter Phone (949)644-3288
e
i LIl i1Y%T
Job Address: 221 SAPPHIRE AVE NB
Inspector Area: 2
Owner: SAILHOUSE SAPPHIRE LLC
Address: 170 NEWPORT CTR OR #220
NEWPORT BEACH CA 92660
Phone:
Applicant: DOUGHERTY HOLT I ASHLEY
Address: 22672 LAMBERT ST #619
LAKE FOREST, CA 92630
Phone: 801-647-6161
Code Edit : 2019
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
2267
Added /New sq. ft. Garage:
352
No of Stories:
3
No of Units :
0
Flood Zone:
X-0.2PCT
Bldg Sprinklers:
Y
FIRE Permit: F2022-0128
Project No : 0643-2022
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SRINKLERS (X2021-0774) 30 HEADS
Legal Description: BALBOA ISLAND SEC 3 BILK 9 LOT 27
Contractor: ALL STAR PLUMBING & FIRE
Architect:
Address: 22672 LAMBERT ST #619
Address:
LAKE1 OREST CA 92630
Phone: 9494f0072
Phone:
State Lic:
Con State Lic: 715588 0/°y
Engineer:
Lic Expire: 08131120230
Address:
Bus Lic: BT30059737 - )
Lic Exp Date: A3112022 V,,
Phone:
State Lic:
Worker's Compensate insurance
Designer:
DOUGHERTY HOLT
Carrier: FALL 'E FIRE & ),IALTY CO
Address:
22672 LAMBERT ST #619
Policy No: FLAG 00 /�
LAKE FOREST CA 92630
Expire: 02/07/2 ��� Phone:
Issued Date: 03/23/2022
Rear:�S,(`� �y Special Conditions: HIGH DENSITY ZONE
Setback- LIQUEFACTION ibNt=
Left:
Right: l�
FEES
Construction Valuation:
$7,000.00
Building PC Fee :
$222.00
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 :
$269.00
TOTAL FEE :
$495.00
Plan Check Fee :
$495.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY: " OTHER DEPARTMENT:
ZONING APPROVAL: _ - PLAN CHECKED BY::
FIRE APPROVAL: 4:11'" APPROVAL TO ISSUE
FERMI r EXPIRES. 180 D 4YS AFTER ISSUANCE OR LAST VALID INSPECTION
DWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indic
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, dem(
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Secti(
not 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 U portions of tt
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through e
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of compl
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, 1
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor
❑ 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 yr
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I unc
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginf
Signature of Property Owner or Authorized Agent
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
and effect.
License Class License No Date
IRS'COMPENSATION DECLARATION
NG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
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
ormance of the work for which this permit is issued. Policy No.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
rance carrier and policy number are:
'ier Policy Number
Ie of Agent
ad below by the checkmark(s) I have placed next to the applicable item(s)
:h, or repair any structure, prior to its issuance, also requires the applicant for
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
work, and the structure is not intended or offered for sale (Section 7044,
ployees' or personal effort, builds or improves the property, provided that the
ion, the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
Icalaw.html.
Date
3 of the Business and Professions Code, and my license is in full force
Contractor Signature
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner sq 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 qomply with those provisions.
Signature of Applicant Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which t iis 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 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.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE MTN
ODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIOPS PA,2(51 OF I
AQMD RULE 1403.
OLE 40 AND
PERMIT EXPdREO
❑ I SUBMITTED ASBESTOS NOTIFIC
❑ EPA
❑ 'AQMD
TAN TO:
PERMITCANCELLED
PERMfTEXTENDED
❑ ASBESTOS NOTIFICATION IS NOTAPPLICABLETO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIRCATEOF
OCCUPANCYISSUED
SIGNATURE:
wi.w (r City of Newport Beach - Building Division 1pi1111111111111111111111111111111111111111111111
b 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
)
Job Address: 221 SAPPHIRE AVE NB
Inspector Area: 2
Owner: SAILHOUSE SAPPHIRE LLC
Address: 170 NEWPORT CTR DR #220
NEWPORT BEACH CA 92660
Phone:
Applicant: DOUGHERTY HOLT / ASHLEY
Address: 22672 LAMBERT ST #619
LAKE FOREST, CA 92630
Phone: 801.647-6161
Code Edit : 2019
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
Construction Valuation:
V-B-SPR
R3/U
2267
352
3
0
X-0.2PCT
Y
Building PC Fee
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Fee
Fire Plan Check Fee:
Fire Permit Fee :
Building Permit Fee
TOTALFEE
PROCESSED BY:
ZONING APPROVAL:
$7,000.00
FIRE Permit: F2022-0128
Project No : 0643-2022
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SRINKLERS (X2021-0774) 30 HEADS
Legal Description:
BALBOA ISLAND SEC 3 ELK 9 LOT 27
Contractor:
ALL STAR PLUMBING & FIRE
Address:
22672 LAMBERT ST #619
LAKE FOREST CA 92630
Phone:
949-470-0072
Con State Lie:
715588
Lie Expire:
08/31/2023
Bus Lie:
ST30059737
Lie Exp Date:
07/31/2022
Worker's Compensation
Insurance
Carrier:
FALLS LAKE FIRE & CASUALTY CO
Policy No:
FLA01837500
Expire:
0210712023
Issued Date: 03/23/2022
Setback- Front:
Rear:
Left:
Right:
FEES
Architect
Address:
Phone: State Lie
Engineer:
Address:
Phone:
State Lie:
Designer:
DOUGHERTY HOLT
Address:
22672 LAMBERT ST #619
LAKE FOREST CA 92630
Phone:
Special Conditions: HIGH DENSITY ZONE
LIQUEFACTION ZONE
$222.00
Fire Residential Alarm PC Fee -"
$0.00
$0.00
Planning Counter Review:
$0.00
$0.00
Planning Zoning PC Fee:
$0.00
$0.00
$0.00
Public Works PC Fee :
$0.00
$0.00
Public Works Traffic Plan Check Fee;
$0.00
$269.00
$495.00
Plan Check Fee :
$495.00
`^
M I
OTHER DEPARTMENT:
FIRE APPROVAL: 3�
PLAN CHECKED BY::
APPROVAL TO ISSUE:
Records Management: $4.00
$0.00
$0.00
Fee Due at Permit Issuance : $0.00
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
'NER-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)
,tion 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
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Lay✓ (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sectiory 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500).
LJ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of tt
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through e
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp)
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, 1
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor
❑ 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 yf
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I unc
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginf,
Signature of Property Owner or Authorized Agent
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
and effect. -5 ? -S .Z.Z
License Class License No Date
RS' COMPENSATION DECLARATION
work, and the structure is not intended or offered for sale (Section 7044,
ployees' or personal effort, builds or improves the property, provided that the
ion, the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
Date
m 3 of the Business and T!�
ns Code, and my license is in full force
Contractor Signa
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI�s AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). 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:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
pe rmance of the work for which this permit is issued. Policy No.
01 ve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
insure ce carrier and policy number are:
m Policy Number
Name of Agent
certify that, in the performal
if I should become subject
of
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
work for which this permit is issued, I shall not employ any person in any manner S4 as to become subject to the workers' compensation laws of California, and
rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith omply with thos"e �provisi99ns.
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
Ireby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which
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 or ces and state laws relating to building construction
I authorize representatives of this city or county to ent bove-identi0ed property for inspection purposes.
of Property Owner or Authorized
permit is issued (Section 3097, Civil Code).
3/7 3
ACTION
DATE
BY
DECLARATIONOF COMPLIANCE IMTH
ODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 51OF I
AQMD RULE 1403.
fTLE40AND
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS NOTIFIC
❑ EPA
❑ AQMD..
TION'TO:
PERPA)TCANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIFICA77ON IS NOT
PROPOSED DEMOLITION.
WPLICABLE TO
PERMIT FINAL
CERTI FICATE OE
SIGNATURE:
OCCUPANCYISSUED