HomeMy WebLinkAboutF2018-0627 - Permits4Yar City of Newport Beach - Building Division
- 100 Civic Center Drive, Newport Beach, CA 92660
H r Permit Counter Phone (949)644-3288
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Job Address: 2615 BLUE WATER DR NB
Inspector Area: 4
Owner: NICHOLSON TOM
Address: 1 CORPORATE PLAZA #110
NEWPORT BEACH, CA 92660.
Phone: 949.872-9067
Applicant:
VO JOHN
Address:
526 N SHADYDALE AV
9543 VICTORIA AVE
SOUTH GATE CA 91790
Phone:
Phone:
Code Edit: 2016
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 -S -SPR
R3/U
0
0
FII�I0�III I�II�I�III0 6 2�� 7 II
FIRE Permit: F2018-0627
Project No: 2785-2018
Inspection Requests Phone (949)644-3255
Description: SFR - FIRE SPRINKLERS FOR NEW SFR (X2016-1968) 44 HEADS
Legal Description: N TR 6385 LOT 41
Contractor:
FIREGUARD SPRINKLER SYS INC
Address:
9543 VICTORIA AVE
SOUTH GATE CA 90280
Phone:
.714.310-0194
Con State Lie:
992002
Lie Expire:
04/30/2020
Bus Lie:
BT30046886
Lie Exp Date:
04130/2019
Worker's Compensation Insurance
Carrier:
.FALLS LAKE FIRE & CASUALTY
Policy No:
FLA0080008.00
Expire:
1212912018
1 Issued Date: 11/29/2018
0 Setback- Front:
Rear:
Y Left:
Right:
Architect
Address:
Phone: State Lie:
Engineer:
Address:
Phone: State Lie:
Designer:
Address:
Phone:
Special Conditions:
o . m.
FEES
Construction ValuatiznY
o c o
$7,000.00
mm®po
Building PC Fee :°
$202.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
$4.00
°Binding Overtime.RG Fee:
$0.00
Planning Counter Review:
$0.00
`Bdtlfiilng Exterliip0`Fee :
$0.00
Planning Zoning PC Fee:
$0.00
.,BudldiFlg Investigation ,Fee:
$0.00
-
$0.00
Fire Plan Check Feu,
$0.00
Public Works PC Fee:
$0.00
$0.00
<Fire.Rarmit Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
`Qu11diog° Permit Fee:
C
$240.00
aeo°ce
TOTAL FEE:
$446.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$446.00
. •�
PROCESSED BY:
OTHER DEPARTMENT:
ZONING APPROVAL:
FIRE APPROVAL
SL\
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
JVYIYCR-OUILUCR UCIiLNR/iI IWII
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) 1 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' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'rofessions 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
lot 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 (_) 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
mprovements 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).
3 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
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).
1 am exempt from licensure under the Contractors' State 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
yell 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
rrofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
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 70 0) of Division 3 of the Business and POISE ons d , a d my license is in full force
Ind effect.
.!cerise pse Class License No Date f I Contractor Signature
VORKERS' COMPENSATION DECLARATION
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 ($700,000), IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
Vidormance of the work for which this permit is issued. Policy No.
and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
carrier and policy number are:
io Policy Number Expiration Date
is of Agent Phone #
certify that, in the perfor ance f the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation IaviWaftaliforni$,°abl(j ol)
It, if I should become subj ct to th wor s' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions s
nature of Applica Date —� 7— ,
CLARATION REG BIN ON TRUCTION LENDING AGENCY V .....
rreby affirm under penalty f pe ury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 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
I have read this application and the information I
I agree to comply with all applicable city and cou )
I authorize representatives of this city or county tI
nature of Prooertv Owner or Authorized Aoent�
ACTION I DATE
• • • o
owner's behalf.
.° o
led is correct. • • v °
,as and state laws relating to building construction.
55rrr,,,. • °
v -identified property for inspection purposes. I �!' : • • •: •
I J— Print Prnnertv Owner's or Authorized ADent's Name (TV7 V V Date °
I PERMITEXPIRED I I I
PERMdTCANCECLED
rP€RMITEXTEMDED I
OCCOPANCYISSUED
❑ I SUf3MfTTEDASS€STOS NDIIFfCATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOITFICATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
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