HomeMy WebLinkAboutF2022-0117 - Permitsa
City of Newport Beach - Building Division pII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII FIRE Permit: F2022-0117
100 Civic Center Drive, New ort Beach, CA 92660 I F 2 0 2 2 0 1 1 7 p Project No : 0625-2022
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 4607 DORCHESTER RD NB
Description: SFR FIRE SPRINKLERS (41) HEADS (X2021-0596)
Inspector Area: 5
Legal
Description:
N TR 3619 LOT 89
Owner: LIEFER MICHAEL & DIANE
Contractor:
FIREGUARD SPRINKLER SYS INC
Architect:
Address: 4607 DORCHESTER RD
CORONA DEL MAR, CA 92625
Address:
7907 LEEDS ST
DOWNEY CA 90242
Address:
Q1
Phone: 949-975-0123
Phone:
714-310-0194
Phone:
State Lie:
"I
Applicant: VO JOHN
Con State Lie:
992002
Engineer:
�y"�
Address: 7907 LEEDS ST
Lie Expire:
04/30/2022
Address:
DOWNEY CA 90242
Bus Lie:
BT30046886
Phone: 714-3100194
Lie Exp Date:
04/30/2022
Phone:
State Lic:
g
�" 9
9
Code Edit : 2019
Worker's Compensation Insurance
Designer:
VO JOHN
Type of Construction: V-BSPR
Carrier:
FALLS LAKE FIRE & CASUALTY
Address:
7907 LEEDS ST
Occupancy Group: R3/U
Policy No:
FLA0080008
DOWNEY CA 90242
Added /New sq.ft. Bldg: 0
Expire:
12/29/2022
Phone:
714-310-0194
Added /New sq. ft. Garage: 0
No of Stories: 1
Issued
Date: 03/09/2022 Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone: X
Rear:
Bldg Sprinklers: Y
Left:
s
Right:
FEES
Construction Valuation: $7,000.00
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:
. e ° ° e ® ° ®� o-OTMItR DEPARTMENT:
ZONING APPROVAL:°4LAN
EHECKED BY::
FIRE APPROVAL: i
-
APPROVAL FO ISSUE:
c s o one ••
Yl
PERMIT EXPIRES 180 DAYS AFTAR 6S!Wfi&10Eb&AST VALID INSPECTION
e
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 (_) 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 are not 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
im roved 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 1 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
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
LICENSand effect. License
CONTRACTOR'S DECLARATION ection 70 0) of Division 3 of the Business and Prof Sion Co , and my license is in full force
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S
License Class - -. _. - - ..License No Date _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:
111 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 thl
p�e o/rrmance of the work for which this permit is issued. Policy No.
FKaIve 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
iii surance carrier and poll umber are: '^/
r—mr e. . 1/Pi Pn�I cv Nu Expiration Date
ne of Agent
certify that, in the pi
. if I should become
J
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
ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision
Signature of Applicant ( v uare-
DECLARATION REGARDINGCONS R CTION LENDING AGENCY
I hereby affirm under penalty of perjuryat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the prope ner's behalf.
I have read this application and the information have pr, vide is correct.
I agree to comply with all applicable city and county oral a es and state laws relating to building construction.
I authorize representatives of this city or count the ab ve-identified property for inspection purposes. �,t
Signature of Property Owner or Authorized Agent - Print Propert Owner's or Authorized Agent's N d' o Dat
AC77ON
DATE
BY
DECLARATION OF COMPLIANCE VATR CODE OF
FOR OFFICE USE ONLY
FEOE#ML!%EGULAT/QNSBART tit QF TI-LE40AND
AQMQ?WLC 4403.
PERMIT EXPIRED
❑;SVB1AIJTMji TGS NONICAYIf1N TO:.
•❑ EPA • • • .
El AQMD
PERMIT CANCELLED
PERMIT EXTENDED
ASBESTOS NORFICATION IS NOT APPLICABLE TO
PROP@SEBD€MOLITION. • •..
• � - • • • •
PERMIT FINAL
CERTIFICATE OF
SIGNATULkE:
OCCUPANCYISSUED
L,