HomeMy WebLinkAboutF2022-0177 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2022-0177
0 i A 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 1 7 7 Project No : 0908-2022
jPermit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
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Job Address: 400 S BAY FRONT NB DescripxvFR FIRE SPRINKLERS (X2021-1685) 26 HEADS
Inspector Area: 2 Legal Description: BALBOA ISLAND RRE��SEC 1 LOT 1 BLK 7 AND LOT 2 BLK 7
Owner: SHERREITT VICTOR BROWNE Contractor: FIREPROOF FIRE PROT�QN Architect:
Address: 400 S BAY FRONT 45 Address: 1101 KINGSI�ON DR //`,(� Address:
NEWPORT BEACH, CA C0631
Phone: 9496759665 Phone: �
7
Phone: State Lic:
Applicant: CASEY MONTY Con State Lic: 876004 Oy '0�r Engineer:
Address: 1101 KINGSTON DR Lic Expire: 04/30/2022 S� J,r /� I Address:
LA HABRA CA 90631 Bus Lic: BT30040107 9�®/ hone: State Lic:
Phone: 714-476-5370 Lic Exp Date: 07/31/2022
Code Edit: 2019 Worker's Compensation Insurance igner: CASEY MONTY
Type of Construction: V-B-SPR Carrier: SECURITY NATIONAL INS '{�® Address: 1101 KINGSTON DR
Occupancy Group: R3/U Policy No: SWC1325710 LA HABRA CA 90631
Added /New sq.ft. Bldg: 0 Expire: 02/15/2023 Phone:
Added /New sq. ft. Garage: 0
No of Stories: 3 Issued Date: 0410512022 Special Conditions:
No of Units : 0 Setback- Front:
Flood Zone: X Rear: _
Bldg Sprinklers: Y Left: Right: -S C
ty r�+,
1 � '
FEES
Construction Valuation: $2,600.00
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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 : $289.00
TOTAL FEE : $495.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $495.00
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VAL,D {NSFEC710{J
DWNER-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 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
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 Iicensure 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 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 Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm1.
Signature of Property Owner or Authorized Agent Date
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 Division 3 of the Business and Professions Code, and my license is in full force
and effect.
License Class License No Date 1 Contractor Signature
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN E LOYER TO CRIMINAL PENALTIES 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 ATTORNErS FEES.
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 Industrial Relations as provided for by Section 3700 of the Labor Code, for the
e mance 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 Expiration Date
is of Agent Phone #
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
, if I should become subject totheworkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. f
lature of Applicant !/� _ L� Date
`I ARATInM RFr R r rnMCTG11rTInM I FMMIMr ArPMrV �—
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 county ordinances and state laws relating to building construction.
1 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 M, f -1 DateALTJ 1 I
AC770M
DATF
gY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403.
PERMITEXPIRED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIRCATEOF
OCCUPANCYISSUED
SIGNATURE:
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