HomeMy WebLinkAboutF2017-0075 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII FIRE Permit: F2017-0075
'- 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 7 0 0 7 5 Project No : 0296-2017
a,. Permit Counter Phone (949)644-3288
+rlKvau Inspection Requests Phone (949)644-3255
Job Address: 1973 PORT PROVENCE PL NB Description: SFR FIRE SPRINKLERS (46 HEADS (X2016-0827)
Inspector Area: 4
Owner:
LANDS END TRUST
Address:
1973 PORT PROVENCE PL
Occupancy Group:
NEPWOR BEACH CA 92660
Phone:
714-310-0194
Applicant:
VOJOHN
Address:
5133 ROSEMEAD BLVD
Occupancy Group:
SAN GABRIEL CA 91776
Phone:
714-310-0194
Code Edit : 2013
N TR 6624 LOT 53
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:
2
No of Units :
0
Flood Zone:
ST30046886
Bldg Sprinklers:
Y
Legal Description:
N TR 6624 LOT 53
Contractor:
FIREGUARD SPRINKLER SYS INC
Address:
9543 VICTORIA AVE
SOUTH GATE CA 90280
Phone:
714.310.0194
Con State Lic:
992002
Lic Expire:
04/30/2018
Bus Lic:
ST30046886
Lic Exp Date:
04/30/2017
Worker's Compensation Insurance
Carrier:
SECURITY NATL
Policy No:
SWC1091874
Expire:
12/20/2017
Issued Date: 02/09/2017
Setback- Front:
Phone:
Rear:
$0.00
Left:
Right:
$225.00
Special Conditions:
a�
Architect:,-
Address:r
Construction Valuation:
$5,500.00
Building PC Fee :
Phone:
State Lie:
tea
Engineer:
Address:
$0.00
Planning Counter Review: $0.00
Phone:
State Lic:
$0.00
Designer:
VO JOHN
Building Investigation Fee :
Address:
5133 ROSEMEAD
$0.00
Fire Plan Check Fee:
SAN GABRIEL CA 91776
_
Phone:
714-310-0194
$0.00
Special Conditions:
FEES
Construction Valuation:
$5,500.00
Building PC Fee :
$190.00
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 :
$225.00
TOTAL FEE :
$419.00
Plan Check Fee: $0.00 Fee Due at Permit Issuance :
$419.00
PROCESSED BY:
• • • • . ° e . •. ° OTHER DEPARTMENT:
�•�. 0 0 0 0 0
ZONING APPROVAL:
o • o o °m o
i ` ° ° ° u ° • o° • ° PLAN CHECKED BY::
0 0 ° ° o°•
FIRE APPROVAL:
APPROVAL TO ISSUE:
•o• o • o oo• o•
0 ..0
PERMIT E`,KPIRFS 180 DA? SQA F TER GSSaVANCE OR LAST VALID INSPECTION
c o c c o
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). -
U I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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
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).
❑ 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 legal
sell 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
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
LICENSED CONTRACTOR'S DECLARATION
I 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 P ofes 'ons Co and my license is in full force
and effect. /-7
License Class License No Date Z q 1 l contractor signature
WORKERS' COMPENSATION DECLARATION
rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION OTOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
DOLLARS ($100,000), IN ADDITION TO THE
I 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
Armance of the work for which this permit is issued. Policy No.
have and will mal tain�irorkers' 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'
*ance carrier and oo' v n tuber are: 1m+ _ I _
Date
is of Agent / �v Phone#
certify that, in the performan of a 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
if I should become subj t t the rk o�ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
�provisiognsJ(/; % '7
Iature of Applicant CS ate \ Li/''T /1 G
:reby affirm underfenalty of perjurrythat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name Lender's Address
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 correct.
I agree to comply with all applicable city and county ordinance an state laws relating to building construction.
I authorize representatives of this city or county to enter at ove-I a'fie �fSoNv r
any for inspection purposes.
efh Pruner,,\` j
of nurser nr A,dhnri,, Anem+ r— a Prim+ orc,nen,.,mee nr Aii hnrhn m
eonr'� Memo /1Dyl ✓l
ACTION DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
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PERMITEXPIRED
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❑ EPA•
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS N07IRCARONIS NOT APFLII;4QL E TO
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PERMITFINAL XC2 NT,PROPOSEDDEAQt9P,1TAX
CERTIFICATE OF
OCCUPANCYISSUED
SIGNATURE: ; : : :
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