The URL can be used to link to this page

Home My WebLink AboutF2020-0465 - Permits (3)117i''City of Newport Beash - Building Division FIRE Permit: F2020-0465 uq� 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 - 0 4 6 5 ` Profect No: 2155-2020 Permit Counter Phone (949)644-3288 (�✓�� Inspection Requests Phone (949)644-3255 X\16 IU _ Job Address: 200 RUBY AVE NB _ Qe QRion: MRBtFIRE SPRI ERS (X2020-0741) 25 DS, Inspector Area: 2 Legal Descnption. ISLAND SEC,2, 1� BLK, O 1l2(AND W112 LOT 18 BLK 10 Owner: DRAKE Contractor FIREGUAR SPRINT SYS INC Architect: -®^t[ Address: 200 RUBY NEWPORTA EACH, CA 92662 -Address: SOUTH GATE9543 I6 2280 Address: NS y 1:/'�TI®N r(R Phone: Ph 714 310-0194`" lJ W i State Lic: Applicant: VO JOHN on State Lic 992002 1 er: Address: 526 N SHADYDALE AV i Lic Expire 0413012022 ress: WEST COVINA CA 91740 /1 �/ Bus Lic BT30046886 p'!1�' t i-S Phone: �V Lic Exp Date: 04/30/2021 -bpe: 0 - �� State Lic: Code Edit : 2019 \O Worker's Compensation Insurance �._„-,PDesigner: O J Type of Construction: -B-SP �� " Carrier. FALLS LAKE FIRE 8, CASUALTY - �5 Addres ' 526 SHADYDALE AV Occupancy Group: R31U ,��`.y - k7';'-_Policy No: FLA0080008 O� o'%WA S`p COVINA CA 91790 Added /New sq.ft. BI V:' Expire 1212912020 .j, P ne r'`•' 714.310-0194 Added /New sq. arage: �� ° 0 `&, No of Stories: ��' 2 t issued Date: 1112312020 Special onditigf High density No of Units: 0, CIOSetback- Front: -10 ads Flood Zone r Rear: `f Bldg Sprinklers: s Left: ,_ - � NS �o Right: g�'� ,J FE Construction Valuation Building PC Fee fro$217. t1.d ire Resident! Alarm P e ^'T $0.00 Records Management: $4.00 Building Overtime PC Fee:` $ Planning nter Re ' w , $0.00 Building Extention Fee: ,.,, -. 0.00 �`�' Planni oningP F� $0.00 Building Investigation Fee: " .00 �a 9" $0.00 Fire Plan Check Fee: .00 blic Wo PC%Fee : $0.00 $0.00 Fire Permit Fee . $0.00 1 y Public or raffic Plan Check Fee; $0.00 Building Permit Fee: $263.00 103 V TOTAL FEE : 484 - t7� P i Check Fee: $0.00 Fee Due at Permit Issuance : $484.00 PROCESSED BY: _ OTHER DEPARTMENT: Nvol ZONING APPROVAL: .�� _ PLAN CHECKED BY:: FIRE APPROVAL: � 1 APPROVAL TO ISSUE: PER) ll7 EXPI:4E3 180'DAYS AFTER ISSUANCE OR LAST VALID INSPECTION LINER -BUILDER DECLARATION;;' I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License law for th ason(s) indicate&:below by the checkmark(s) I have placed next to the applicable items) fiction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, r, Improve, demolish, �Rt repair any structure, prior to its issuance, also requires the applicant for permit to file a signed statement that he or she is licensed pursuant to the provisions of the Con . ors' State License Law h ter 9 (commencing with Section 7000) of Division 3 of the Business and ifessions Code) or that he or she is exempt from licensors and the basis for the alleged exe n. Any violation of Se56(gA V0,11. y any applicant for a permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). ,a I, as owner of the property, or my employees with wages as their sole compensati. will dp �Yry�r}� siness and Professions Code: The Contractors' State License L;ho 9contracts yto an owr� c%ropE )rovements are not intended or offered for sale. If, however, theovemen YdId within! )roved for the purpose of sale). �� ` 0 O I, as owner of the property, am exclusively contracting with lice to constrNL��p�� projE )ly to an owner of property who builds or improves thereon, r the of Ct5 with a lir I am exempt from licensure under the Contractors' St icense Law f e following reason: (_) �a� Rs of the work nd a structure is not intended or offered for sale (Section 7044, r hrough amp ees' or Sono) effort, builds or improves the property, provided that the t� year of com Ian, the Owne wilder will have the burden of proving that it was not built or (Se 7044, Business and Profs ions Code: The Contractors' State License Law does not is Contractor pursuant to the Contr tors' State License Law). my signature below I acknowledge that, except for personal rest nce in w h I must he Ided for at least one year prior to completion or a structure that I have built as an owner -build - it has not be constru , Irt i� entirety't, licensed contractors. I understand that a copy of the Ifessions Code, is available upon request n this applies " is sub r� 4efi�o at'tRe. f: ing Web site:http://w .leginfo.ca.gov/calaw.html. nature of Property Owner or Authonz gent nents covered by this permit, I cannot law, Section 7044 of the Business and Date I hereby affirm under pen III y t th� ensed unde"Y provisions of Chapter 9 (commencing with Section 700 ) of Divisi � Business and P�rs(jessi ns Code, and my license is in full force and effect License Class Llcgnse No Date I/ Cdritractor Signal ORKERS' CO ENSATI CLARATdON \\ll WARNING: FAIL TO SECUrf��AwN ERS' CO TION COVERAGE T UNLAWFUL; AND SHALL SUBJECT AN EMPLOYER TO C Y L LTIErrSxx NIL FINES UP T HE HU THO[rSAND DOLLARS (E100,000), IN ADDITION TO THE COST OF CO ENSATION, dAtI�AGES AS PRO 0 F R IN SECTION ]]O6 OF THE LABOR CODE, INTEREST, AND ATTORNEPS.F. r>`p• I hereby a under penalty ofperjury e of tt following declarations: have. and- will maintain "a certificatef consent to self insure for workers' compensation' issued bythelicor of Industr' elatio'as p d for by Section 3700 of the Labor Code, for th pe_ ormance of the work for which this permit is issued- Policy No.a�y+- Dave and will maintain workerscompensation insurance, as required by Section 3700 of the Labor Code, for the rform�Cle of the work for which this permit is issued. My workers' compensatio i ance carrier and. policy number are r i . ,'Alicy Number Expiration Date Name of Agent ? Phone # I certify that, in that pe n o e or which this permit is issue sh 11 not employ an rson in a ma13 r so as to become subject to the workers' compensation laws of California, and agre that, if I should becorr+� gu t to IS' compensatwn�prbvisions of $� n 3700 of the or Code a "rthwith comply with those provisio Signature of ApplicanfX� _ Date`, DECLARATION REGARDIN STRU TI L - NB AGENCY ,,pp I hereby affirm under penalty of p (Dry th is WnsfrylrJlt'o' �djp gan or the pe of the work for which this permit is issued (Section 3097, Civil Code). Lender's Named Le is ress By my signature below, I certify toe h of I owing: I am the property owner or author) d to act on the p arty o er's behal I have read this application and the I formation I he e p ad is Corr I agree to comply with all applicable c and co p In ces St aws relating to building construction. f I authorize representatives of this city o nter th ve ntified property for inspection purposes. _, p �� Date (� Signature of Property Owner or Authorized A Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE KITH CODE OF FOR OFFICE USE ONLY FEDERAL REGUL/.TIONS DART 61 OF TITLE40 AND AQMD RULE f4O3. ❑1SUBMITTEDASBE:.TOSRODFICATIONTC: ❑ EPA ❑ AQMD PERMITEXPIRFD /0-/0-t'L_- �� PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NO71FICARON IS NOT APPLICABLE TO PROPOSEDDEMOLIT'CN. PERMIT FINAL _ -- CERTIFICATEOF SIGNATURE:. OCCUPANCYISSUED