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HomeMy WebLinkAboutF2023-0101 - Permits�gWPORT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II p� d Community Development Department- Building Division F 2 0 2 3 0 1 9 1 F 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 c94 coaN�P newportbeachca.gov/inspections Combination Type - SFP Work Class - Addition/Alteration COMB Permit: F2U23-U1 �� Plan Check No: PC2023-0433 Issued Date : 03/01/2023 Inspection Area : 5 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 Job Address : 18 ARCHIPELAGO DR Legal Desc : N TR 15817 BLK LOT 4 Description: SFR FIRE SPRINKLER SYSTEM 74 HEADS (X2022-1106) Owner: DEMIA INVESTMENT GROUP LLC Contractor: KELLY FIRE PROT INC Architect Address : 43 BRIDGEPORT RD Address : 10141 THESEUS DR Address NEWPORT COAST, CA 92657 HUNTINGTON BEACH, CA 92646 Phone : Phone : (714) 907-7586 Phone Con State Lic : 878823 State Lic Lic Expire: 08/31/2023 Applicant: KELLY FIRE PROT INC Bus Lic : BT30070761 Engineer: Address : 10141 THESEUS DR Bus Lic Expire : 01/31/2024 Address HUNTINGTON BEACH, CA 92646 Phone: (714) 907-7586 Workers' Compensation Insurance Phone: Carrier: AMERICAN FAMILY HOME INSURANCE CO Owner/Builder : Policy No: 2EA5WC0000246 Designer: KELLY FIRE PROT INC Address: W. C. Expire : 4/11/2023 Address : 10141 THESEUS DR HUNTINGTON BEACH, CA 92646 Phone: Phone: (714) 907-7586 Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : $7,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg: 0 Occupancy Groups : R3/U No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 2 Added/New sq. ft. Garage: 0 TOTAL sq. ft. 0 Building Setbacks Flood Zone : X Use Zone : PC- Newport Coast PROCESSED BY: .51 SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt front the Contractors' State License Law for the reason(s) indicated below by the checkrnark(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 he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Lots (Chapter 9 (commencing with Section 7000) cf 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 of more than five hundred dollars ($500). 11, 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, 3usiness 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 laprovements 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 mproved for the purpose of sale). 1 1, 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 cply to an owner of property who builds or Improvesthereon, and %he contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licansure under the Contractors' Slate License Law for the following reason: 3y 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 ithas not been constructed in Its entiroty by licensed contractors. I understand that a copy of theapplicable law. Section 7044 of the Business and 'rofessions Code., is available upon request when this application is submitted or at the following Web site:http:liwww.leginfo.ca.gov)calaw.html. Signature of Property Owner or Authorized Agent _ Date -ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of fpivisfon 3 of the Business and Professions code, a,d y license is In full force and effect. License Class License No Do� 3 — j - s 3 Contractor Signarl PORKERS' COMPENSATION DECLARATION V IARNING: 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 (6t00,0001. IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706. OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm underpenalty of perjury one of the following declarations: -11 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 911ermance of the work for which this permit is issued. Policy No. and will maintain workers' compensation insurance, as required by Section 3700 of the Lahor Code, for the performance of the work for which this permit is issued. My workers' carrier and policy number are: Policy Number is of Agent certify that, in the performance of the work for which this permit is issued. I shall , if I should become subject to. a workers' corrdpensation provisions of Se rehire of Applicant 11 /fly--\ Date employ anyperson in any manner so as to become subject to the workers' compensation laws of California, and I of the Labor Code. I shall forthwith comply vain those provisions. r)ele areby affirm under ;penalty of perjury that there is a con ction to g agency for the performance of the work for which this permit is issued (Section 3097,. Civil Code). Ides s Name Lender's Address my signature below, I certify to each of the follo ng: I am the property owner or authorized to act erty 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 of cDgnty to eyter the above-Idegliftad property for inspection purposes. f , of Property Owner or Authorized AM t /� --. 140 j Print Property Owner's or Authorized Ag DATE J E19 I 8rECLARATlCN`0SX!!S*frRNCE W17H CODE OF FEDERAL I FOR OFFICE USE ONLY PERNiT EA PhF c PEPMIT CHN(ELLEU PERWFINAL CERTIFFCATE OF OCCUPANCY ISSUED REGULATIONS PART at OF TITLE An AND AONID RULE IJ,A$BE$TO5 NOTIFICATION 15 NOT APPLICABLE 70 PROPOSED DEMOLITION