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Home My WebLink AboutF2023-0421 - Permitsagvwno�T City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: F2U23-0421 p� A Community Development Department- Building Division P 2 0 2 3 0 a 2 1 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-2136 Permit Counter Phone: (949) 718-1888 Issued Date : 08/31/2023 T newportbeachca.gov/civic Final Date: Combination Type - Permit Status: Issued Work Class - Tenant Improvement Inspection Area : FIRE PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS V-10I.-ri ME Job Address: 2116 NEWPORT BLVD Legal Desc : N TR 814.BLK LOT 17 TR 814 LOTS 17/18 Description: COMM FIRE SPRINKLER SYSTEM 3 HEADS (X2022-1397) Owner: WASKO JAMES M TR THE ROUBIAN FAMILY Contractor: KELLY FIRE PROT INC TR Address : 10203 OVERHILL DR Address : 10141 THESEUS DR SANTA ANA, CA 92705 HUNTINGTON BEACH, CA 92646 Phone : Phone : (714) 907-7586 Con State Lie : 878823 Lie Expire : 08/31/2025 Applicant: KELLY FIRE PROT INC Bus Lie: BT30070761 Address : 10141 THESEUS DR Bus Lie Expire : 01/31/2024 HUNTINGTON BEACH, CA 92646 Phone: (714) 907-7586 Workers' Compensation Insurance Carrier: INSURANCE CO OF THE WEST Owner/Builder : Policy No: WVE507050500 Address : W. C. Expire : 4/11/2024 Phone Code Edition : 2022 Fire Sprinklers : YES Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : No of Units : 0 Bldg Height: No of Stories : Building Setbacks : Flood Zone : X Use Zone : MU-W2 - Mixed -Use Water PROCESSED BY: �. SPECIAL CONDITIONS: Architect Address Phone: State Lie Engineer: Address Phone: Designer: KELLY FIRE PROT INC Address : 10141 THESEUS DR HUNTINGTON BEACH, CA 92646 Phone: (714)907-7586 Construction Valuation : $1,200.00 Added/New/TI sq. ft. Bldg : 0 Alteration sq. ft. Bldg : Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 ¢¢ } 7 y d r 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 checkmarkjs) I have placed next to the applicable ttem(s) Section 7031.5, Business and Professions Code; Any city or County Uiat regoires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for he permit to file a signed statement that lie or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 0 (commencing with Section 7000) of Division 3 of the Business and 'rofessions Code) or that he or she is exempt from licensors 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 lot more then five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure Is not intended or offered for sale (Section 7044, justness 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 mproverri 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 bulb or mprovodfor 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 ipply 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 Ucensure under the Contractors' State License Law for the following reason _ i,y my s➢gnatum below I acknowledge that, except for my personal rasidence in which I must have resldod for at least one year prior to completion of the Improvements covered by this poinut, i cannot logall', all a structure that I hava built as an owner -builder if it has not boon constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Soction 7l)" oftho Businoss and 'rofessions Code, is available upon request when this application is submitted or at the following Web site: http:lArv,vr.leginfo.ea.govlealow,html. Signature of Property Owner c- Aut',n,rized Agent _,_,_ __..._..__ Date .ICEN.SED CONTRACTOWS DECLARATION hereby affirm under peralty (if perjury that I am licensed under previsions of Chapter 9 (commencing with Section 00) of Division 3 of the Business and Profs sip �c CvCade, ands 5Y license is in full force Ind effect. LicenseGlass License No Dat I- Contractor Sigma#Ira �C "Y- VORKERS' COMPENSATION D CLARATION fARNING FAILURE TJ S. -CURE WORKERS'COMPENSATION COVERAGE IS UNLAwrUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE WUNOR THOUSAND DOLLARS t8100,000), IN ADDITION TO THE 'DST OF COMPENSAI n.N, OAMADESAS PROVIDED FOR IN SECTION 0706. OF THE LA90R CODE, INTEREST, AND ATTORNE't'S FEES, hereby affirm under nmmri€y of perjury one of the following declarations: I I have and will maintain a certificate of consent to sell -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th prformanee of the work for whiLin [ills ommit Is issued, Polley No. fiava and will mni itak, workers compensateirl insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued, My workers' compansatlo nsu. ca carrier and pol:::y num3,r a,e: �arler Policy Number Expiration Date Vamo of Agent Phone 9 :1I certify that, in the performance of the work for which this permit is issued. 1 shall not employ any person to any manner so as to become subject to the workZip[ 'mpensation laws of California. and Agra hat, If I should become bl t t0 the WgAars' compensation ovisions of Secti -ifi00 of the Labor Code, I shall forthwith comply with those provisions. �tI Signature of Appli Elf __ _G/ (,�!'✓ Dat DECLARATION R!<GARSTGTION tEND(N AGEm.. --- hereby affirm under pen ty of per ury that there is a construe n lending agen for the performance of the work for which th€s permit is issued (Section 3097,ode). _ender's Name Lender's Address _� ......._..__�a ._._ 3y my signature below, i Certify to each Of the following.: I an tare 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 wrath ail applicable city and coot y or lnances and state laws relating to building Construction, I authorize representatives of this city or coun t enta he above•Ide led property for inspection purposes. 9 ' Signature of Property Owner or Authorized Agent Print Property owner's or Authorized A ent's Name ��-�✓ / ate ACTION I DATE 1 BY beLARATIONOr COMPLIA i CODE OF rrDFRAL FOR OFFICE USE ONLY I KGULATIONS PARTUI r T4T1.E40 NOAQMORUI.E 1403 PERr ITEXPIRED 3LJ ISUBMI7,1 ASBES OTIFICATION TO PfRhttt('ANCEtLEO € . -�E1A PCRi Mit EXTENDER. ...._ i �QMD ..._ _....... PCRNH7 f INAL _—_ r�.� �y[-�-F ...%J aZf (�/�%i2f�ASBE5TO5 NOTiF➢CAf10N 15 N01�APpLICABLk IQ _.._.. CER'EIFICAi`f OF I —'[ —P PIUIPOtFrn nFMni iTenN