HomeMy WebLinkAboutF2022-0173 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIII II
t r 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 1 7 3
p
Permit Counter Phone (949)644-3288
Job Address: 217 VIA KORON NB
Inspector Area: 2
Owner: HART
Address: 217 VIA KORON
NEWPORT BEACH, CA 92663
Phone:
Applicant: CASEY MONTY
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone: 714-476-5370
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:
V-B-SPR
R3/U
0
0
FIRE Permit: F2022-0173
Project No : 0863-2022
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS (X2021-3384) 10 HEADS
Legal Description: TR 907 LOT 675(AND SWLY1/2 LOT 674(AND NELY1/2 LOT676
Contractor:
FIREPROOF FIRE PROTECTION
Architect:
Address:
1101 KINGSTON DR
Address:
LA HABRA CA 90631
Phone:
714-476-5370
Phone:
Con State Lic:
876004
Engineer:
Lie Expire:
0413012022
Address:
Bus Lie :
BT30040107
Lie Exp Date:
07/31/2022
Phone:
Worker's Compensation
Insurance
Designer:
Carrier:
SECURITY NATIONAL INS
Address:
Policy No:
SWC1325710
Expire:
02/1512023
Phone:
2 Issued Date: 03/31/2022 Special Conditions:
0 Setback- Front:
X Rear:
Y Left:
Right:
Construction Valuation: $1,000.00
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:
FIRE APPROVAL:
FEES
$222.00
Fire Residential Alarm PC Fee
$0.00
Planning Counter Review
$0.00
Planning Zoning PC Fee
$0.00
$0.00
Public Works PC Fee
$0.00
Public Works Traffic Plan Check Fee;
$269.00
$495.00 Plan Check Fee :
State Lie:
State Lie:
CASEY MONTY
1101 KINGSTON DR
LA HABRA CA 90631
Eli
$0.00 Records Management : $4.00
$0.00
$0.00
$0.00
$0.00 $0.00
$0.00
$0.00 Fee Due at Permit Issuance : $495.00
OTHER,.OEPARTMENT:
FL AN CHeCKED BY::
- ' APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OIZLAST VALID INSPECTION
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 L) all of or L) 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).
❑ 1 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 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 ofthe 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.html.
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. �I
License Class License No Date �1 Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE 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
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:
❑ 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, forth(
rformanndw..rmane ofthe work for which this permit is issued. Policy No.
ve 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' compensatior
t nce carrier and policy number are:
Policy Number Expiration Date
of Agent
certify that, in the performance of the work forwhich 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
I, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 1
nature of Applicant ���"�� Date 3,J t
CLARATION REGARD G CONSTRUCTION LENDING AGENCY
)reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is is Zed 3097, Civil Code).
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 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.
nature of Property Owner or Authorized Agent ti, :/� Print Property Owner's or Authorized Agent's Name ,___Date 2LILI
ACTION
DATE
BY
DECLARATION OF COMPLIANCE IMITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
A QI#D RI fLE 1403.
PERMIT EXPMED
❑ I SUBMITTEDASLEETOS NORFICATIONTO:
❑ EPA
C AQMD
PERMIT CANCELLED
PERA41T EXTENDED
❑ ASBESTOS NOTIFICATION IS NJT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
Q
CERTIFICATEOF
SIGNATURE:
OCCUPANCYlSSUED