HomeMy WebLinkAboutF2022-0327 - Permits1 �ewtgr4J City of Newport Beach - Building Division IIII�IIIIIIIIII�IIIIIIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 3 2 7
Permit Counter Phone (949)644-3288
a � x
Job Address: 110 APOLENA AVE NB
Inspector Area: 2
Owner: BURNS CLINT
Address: 110 APOLENA AV
NEWPORT BEACH CA 92662
Phone:
Applicant:
VU ANTHONY
Address:
1621 W SUMAC LANE
ANAHEIM, CA 92802
Phone:
714-234-9633
Code Edit : 2019
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
V-B-SPR
R3/U
0
0
FIRE Permit: F2022-0327
Project No : 1634-2022
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLER SYSTEM 31 HEADS (X20220148)
Legal Description: BALBOA ISLAND SEC 3 BLK 6 LOT 25
" Contractor: XFIRE PROTECTION Architect: re 3 e �,...� &� -r1 ,
Address: 9182 ALN/ICK CIR Address:
GARDEN GROVE CA 92841
Phone: 714-231-5108 Phone: State Lic: ,
Can State Lic: 1084661
Lic Expire: 12/31/2023
Bus Lic: BT30077912
Lic Exp Date: 02/2812023
Workees Compensation Insurance
Carrier: NO EMPLOYEES
Policy No:
Expire:
3 Issued Date: 06/28/2022
0 Setback- Front:
Rear:
N Left:
Right:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
State Lic:
VU ANTHONY
1621 W SUMAC LANE
ANAHEIM, CA 92802 '
FEES
Construction Valuation:
$3,900.00
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
$0.00
Building Investigation Fee :
$0.00
$0.00
Public Works PC Fee :
$0.00
$0.00
Fire Plan Check Fee:
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: l_J 0 � OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
ILDER 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
Ithe 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 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
improved 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).
I am exempt }rom,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 t:i. t 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
Professions Cade, 's available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
S igna:ure of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I heresy affirmJnder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing ith Section 7000) of Division 3 of the Business a essl ns Code, nd my license is in full force
ano =rfect. /n1/
,License Class _ License No Date , —Contractor Signatur
WORKERS' COMPENSATION DECLARATION
WARNING' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOO E NDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
r'OFT OF ;OMPENSATION, bAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm and-ar penalty of perjury one of the following declarations:
have and 'dill 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
'mance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
me of Agent
I certify that, in the pert r ante of the work
It, if I should becom �� the ,.•�.o-=�='
'signature of Applicant
IECLARATION REG R CONSTRUCTION
hereby affirm under pens ty of perjury that there
Ender's Name
'y my signature below, I certify to each of the foe,
I am the property owner or authorized to act
I have read this application and the informal c
I agree to comply with all applicable city an
I authorize representatives of this cityffi
Policy Number
Date
hich this permit is issued, I shall not employ any person in any manner so as to becomes ject to the workers' compensation laws of California, and agree
oensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos pr isionls.
Da 1. fl
:NDING AGENCY
a construction lending agency for the performance of the work for which this permit is iss ed (Section 97, Civil Code).
Lender's Address
is property owner's behalf.
have provided is corregt.
laws relating to building construction.
ad property for inspection purposes.
Print Property Owner's or Authorized
ACTION
DATE
BY
DECLARATION OF COMPLIANCE KITH CODE OF
FOR OFFICEIUSE ONLY
FEDERAL REGULATIONS PART b'1 OF TIRE 40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS NOTIFICATIONTO:
❑ EPA
❑ AOMD
PERMiTCANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIRCATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
yeti Foti Q
CERTI4CA TE OF
OCCUPANCYISSL'ED
SIGNATURE:
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