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HomeMy WebLinkAboutF2021-0463 - PermitsruF City of Newport Beach - Building Division II II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 4 6 3 Permit Counter Phone (949)644-3288 ''t�tsi¢lntT Job Address: 19 POINT LOMA DR NB Inspector Area: 6 Owner: PETROFF CHRIS & JILL Address: 19 POINT LOMA DR CORONA DEL MAR, CA 92625 Phone: Applicant: GUTIERREZ RUBI Address: 8085 E CRYSTAL DR ANAHEIM CA 92807 Phone: 714-666-8450 Code Edit: 2019 Type of Construction: V-B-SPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Flood Zone: X Bldg Sprinklers: Y Construction Valuation Building PC Fee: Building Overtime PC Fee Building Extention Fee: Building Investigation Fee Fire Plan Check Fee: Fire Permit Fee Building Permit Fee TOTALFEE PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: $10,596.00 FIRE Permit: F2O21-0463 Project No : 2330-2021 Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLERS (63) HEADS (X2021-0660) Legal Description: N TR 7432 LOT 51 Contractor: RESIDENTIAL FIRE SYSTEMS INC Architect: z Address: 8085 E CRYSTAL DR Address: ANAHEIM CA 92807 Phone: 714-666-8450 Phone: State Lic: 13 Con State Lic: 786965 Engineer: Lic Expire: 11/30/2022 Address: 1 Bus Lic: BT30003809 Lic Exp Date: 04/30/2022 Phone: State Lic: .. 1 Worker's Compensation Insurance Designer: GUITIERREZ RUBI Carrier: PACIFIC COMP. INS Address: 8085 E CRYSTAL DR Policy No: REWC019434 ANAHEIM CA 92807'� Expire: 09/01/2022 Phone: 714-666-8450 • •s Issued Date: 10/04/2021 Special Conditions: Setback- Front: Rear: Left: Right: FEES $222.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $10.00 $0.00 Planning Counter Review: $0.00 $0.00 Planning Zoning PC Fee : $0.00 $0.00 $0.00 $0.00 Public Works PC Fee : $0.00 $0.00 $0.00 Public Works Traffic Plan Check Fee: $0.00 $269.00 $501.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $501.00 OTHER DEPARTMENT �LAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXFIR_—S 16J LAYS AFTEH 'SSUANCE OR LAST VALID INSPECTION MNER-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 ie 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 Iicensure 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 of 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, 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 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 nproved for the purpose of sale). 1 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 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). 7 I am exempt from Iicensure under the Contractors' State License Law for the following reason: ly 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 ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://wwv,. leginfo.ca.gov/calaw.html. '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 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. Il O I04 I21 icense Class License No Datf Contractor Signat C �' 6y' 11ORKERS' COMPENSATION DECLARATION 'ARNING: 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 I$100,0001, IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 I �H,e,ve 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 er`91ance of the woot4gr which this permit is issued. Policy No. have and will mat In orkers' 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' rance carrier and policy bumber apt'. - P � Date Name of Agent V/ .K�X_d )_ L l 1/ J— Phone# ❑I certify that, in the performan 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 laws of California, and agre that, if I should become subj3pno the 1'workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr visions. - �^A' ` Signature of Applicant "Kc , Dat t� I O� I2j DECLARATION REGAKDINO CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that 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 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 and state laws relating to building construction. I authorize representatives of this city, or county er the bovee-identified property for inspection purposes. Signature of Property Owner or Authorized Agent I Q_ -Nl Print Property Owner's or Authorized Agent's Name 61 Ut1eXye7__ D LO tb4�z"1 ACTION DATE BY DECLARATION OFCOMPLIANCE MTN CODE OF _ FOR OFFICE USE ONLY FEDERAL ?L GU'.AT1ONS PART 61 OF TITLE 40 AND AQMD RUI E 14J7.- PERMITEXPIRED ❑ LSUBi+IITTcDAS.9EST13SNC1RFICAt70NTO: ❑ SPA - ❑ AQMD PERMIT CANCELLED PERMITEXTENOED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED OLOOLITION. - PERMIT FINAL CER7IFICATEOF OCCUPANCYISSUED _ SIGNATURE: - - -