HomeMy WebLinkAboutF2021-0401 - Permitsw' City of Newport Beach -Building Division *F2021-0401*
e' 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 1107 OXFORD LN NB
FIRE Permit: F2021-0401
Project No : 2123-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLER SYSTEM 36 HEADS (X2021-2407)
Inspector Area: 3 Legal Description: N TR 3031 LOT 6
Owner: QUIER CASEY AND CLAIR
Contractor:
FIREGUARD SPRINKLER SYS INC
Architect:
Address: 1107 OXFORD LANE
Address:
7907 LEEDS ST
Address:
NEWPORT BEACH, CA 92660
DOWNEY CA 90242
Phone:
Phone:
714-310-0194
Phone:
Applicant: VO JOHN
Con State Lic:
992002
Engineer:
Address: 526 N SHADYVALE AVE
Lic Expire:
04/30/2022
Address:
WEST COVINA, CA 91790
Bus Lic:
BT30046886
Phone: 714-310-0194
Lic Exp Date:
04/30/2022
Phone:
Code Edit : 2019
Worker's Compensation
Insurance
Designer:
Type of Construction: V-B-SPR
Carrier:
FALLS LAKE FIRE & CASUALTY
Address:
Occupancy Group: R3/U
Policy No:
FLA0080008
Added /New sq.ft. Bldg: 0
Expire:
12/29/2021
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 2
Issued Date: 09115/2021
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: N
Left:
Right:
State Lic:
State Lic:
VO JOHN
526 N SHADYVALE AVE
WEST COVINA, CA 91790
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FEES
Construction Valuation:
$6,000.00
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 :
$269.00
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 VALID INSPECTION
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.priorto 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 ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements slant intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or
improved for the"40se of sale).
•••1*as ownerd the�roperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply% an ow•ne: of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
• • lam exemptirom licensure under the Contractors' State License Law for the following reason:
By"signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall
9 11 a -structure M??lave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
,$ippgture of Property Owner or Authorized Agent Date
,I•IWSED COIMACTOR'S DECLARATION
I� a ��by affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wi Sectio 7000) of Division 3 of the Business a dJrfessi ns Q'Qde(and my license is in full force
'License•Class•••• License No Dat _` �> ( Contractor Signatur l+r
LGMERS' Cfl.NP�NSATION 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:
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
performance 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. My workers'
arti r and olic number are: /� (�
la L5 rG/Z'_ Policy Number FLA 00 5 0 � Expiration Date IZ
me of Agent
I certify that, in thWtoe
e wor for which this permit is issued, I shall not employ any person in any manner so as to become
lat, if I should beco e ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with the
ignature of Applica D;
IECLARATION RECTION LENDING AGENCY
hereby affirm undethat there is a construction lending agency for the performance of the work for which this permit is is:
Ender's Name Lender's Address
y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the on
I have read this application and the information I have
I agree to comply with all applicable city and county 1
I authorize representatives of this city or county t rite
,ignature of Property Owner or Authorized Agent
ier's behalf.
is correct.
and state laws relating to building construction.
,ve-identified property for inspection purposes.
Print Property Owner's or Authorized
to the workers' compensation laws of California, and
(Section 3097, Civil Code).
VQ
ACTION
DATE
DECLARATION OF COMPLIANCE IA4TH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OF TITLE40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTEDASSESTOS NOTIFICATION' TO:.
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
0 OPOSEDASESrDEMOOS U flNATION IS NOT APPLICABLE 70
PERMIT FINAL
CERTIFICATE OF
SIGNATURE:.
OCCUPANCYISSUED