HomeMy WebLinkAboutF2020-0319 - Permits (2)t r�wrw City
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- Building
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'e. Permit Counter Phone (949)644-3288
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Job Address: 4621 ORRING TON RD NB
Inspector Area: 5
Owner: WELLING GLEN & LAURI
Address: 4621 ORRING?'ON RD
CORONA DEL MAR, CA 92625
Phone:
Applicant: CASEY MONTY
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone: 714-476-5370
Code Edit: 2019
Type of Construction: Ve
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 0
Flood Zone:
Bldg Sprinklers: Y
Construction Valuation
Building PC Fee:
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Ft:e:
Fire Plan Check Fee:
Fire Permit Fee :
Building Permit Fee
TOTAL FEE
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL
$6,600.00
FIRE Permit: F2020-0319
Project No : 1365-2020
Inspection Requests Phone (949)644-3255
Description: SFR - FIRE SPRINKLERINEW SFR 66 HEADS (X2019-2820)
1365-2020
Legal Description: N TR 3357 LOT 67
Contractor:
FIREPROOF FIRE PROTECTION
Address:
1101 KINGSTON DR
LA HABRA CA 90631
Phone:
714-476-5370
Con State Lic:
876004
Lic Expire:
04/30/2022
Bus Lic:
BT30040107
Lic Exp Date:
0813112021
Worker's Compensation Insurance
Carrier:
NORGUARD INS CO
Policy No:
MOWC148394
Expire:
02116/2021
Issued Date: 09103/2020
Setback- Front:
Rear:
Left:
Right:
FEES
$202.00
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;
$240.00
$448.00
Plan Check Fee:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
$0.00
$0.00
$0.00
$0.00
$0.00
State Lic:
State Lic:
CASEY MONTY
1101 KINGSTON DR
LA HABRA CA 90631 `
INS ' %a I
CTOR
Records Management: $6.00
$202.00 Fee Due at Permit Issuance
• OTHER DEARTAUT: 04O •o+
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APPROVAL TO ISSUE: _
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PERMIT EXPIRES 180 DAYS AFTER ISSU/jVV OftLASS VALID AJSPEC:TION
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$0.00
$0.00
$246.00
)WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to thn applicable item(a)
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
is 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 Divisio1 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 appii amt to a civil penalty of
of more than five hundred dollars ($500).
3 I, as Owner of the property, or my employees with wages Be their sale compensation, will do V all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements are not intended or offered forsale. 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
nproved for the purpose of sale).
11, 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
pply 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).
31 am exempt from licensure under the Contractors' State License Law for the following reason:
ty my signature below 1 acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by It is permit, I cannot legally
ell a structure that I have built as an owner -builder H it has not been constructed In its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 D i the Business and
rrofessidns Code, is available upon request when this application is submitted or at the following Web site:http:/Am .leginfo.ca.govlcalaw.html.
lignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, al license is in full force
end effect
.!cerise Class License No Date ��?-rti4� Contractor Signatures
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALT. SUBJECT AN EMPLOYER TO CRIMWAL PQIALTIPS AND CIVIL FLUES UP TO ONE HUNDRED THOUSAND DOLLARS (S'.D%000), IN ADDITION TO THE
:OST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 37W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
31 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
erlill mance of the work forwhich 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. Mr workers'
carrier and policy number are:
Policy Number
Date
IS of Agent Phone #
certify that, in the performance of the work for which this armit 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 subjjPC-te-the orkers' compe safion pro " ' ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date V \01 22L �
CLARATION RE RDING CTION LENDIN CY—S
:raby Still under penalty of perjury that there is a conskiiisfibn lending agency for the performance of the work for which this permit is issued (Section 3097, CrvH Code).
Ider's Name Lender's Address
my signature below, I cal 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 ands relating to building construction.
1 authorize representatives of this city or county tp-ellferthe�bpw><iderrted propertyforinspectlon purposes. h
ACTION
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