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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,