HomeMy WebLinkAboutF2016-0472 - Permitswry�4 City of Newport Beach - Building Division 111111 11111111111111111111111 111111r11111 11111111111111 Jill
t3' ` 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 6 0 4 7 2
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'�. Permit Counter Phone (949)644-3288
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Job Address: 1011 KINGS RD NB
FIRE Permit: F2016-0472
Project No: 2046-2016
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS (42) HEADS (X2016-2186)
Inspector Area: 2 Legal Description: P BK 199 PG 18 PAR 1
Owner: DELISCU FAMILY TRUST
Contractor:
FIREGUARD SPRINKLER SYS INC
Architect:
Address: 1010 KINGS RD
Address:
9543 VICTORIA AVE
Address:
NEWPORT BEACH, CA 92663
SOUTH GATE CA 90280
SOUTH GATE CA 90280
Phone:
Phone:
714.310.0194
Phone:
Applicant: VO JOHN
Con State Lic:
992002
Engineer:
Address: 9543 VICTORA ST
Lic Expire:
04/30/2018
Address:
SOUTH GATE CA 90280
Bus Lic:
BT30046886
Planning Zoning PC Fee :
Phone: 714-310-0194
Lic Exp Date:
0 413 012 01 7
Phone:
Code Edit: 2013
Worker's Compensation Insurance
Designer:
Type of Construction: V-BSPR
Carrier:
SECURITY NATL
Address:
Occupancy Group: R3/U
Policy No:
SWC1091874
Public Works Traffic Plan Check Fee;
Added /New sq.ft. Bldg: 0
Expire:
12/20/2017
Phone:
Added /New sq. ft. Garage: 0
TOTAL FEE :
No of Stories: 2
Issued Date: 04/04/2017
Special Conditions:
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: Y
Left:
Right:
r -
State Litt--
State
itt: 'State Lic: °
ae¢f a a c
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VO JOHN
6
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9543 VICTORIA AVE
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$5,500.00
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SOUTH GATE CA 90280
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714310.0194
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o°iofo
Building PC Fee:
Qp]•f4
f
$0.00 Records Management:
�
Building Overtime PC Fee:
$0.00
Planning Counter Review:
o¢omm•
Building Extention Fee :
$56.00
Planning Zoning PC Fee :
e e
ease
Building Investigation Fee:
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 :
$56.00
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 :
$475.00
Plan Check Fee:
$132.24 Fee Due at Permit Issuance :
$342.76
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 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).
U I am exempt.foo"licensure under the Contractors' State License Law for the following reason:
By my signaturg 1J@IPWI 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
iq%%§Jucture jtW 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 Cade, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Properly dwner or Authorized Agent Date
LICTSNSED COhiTRACTOR'S DECLARATION
14ereby affirm y11det�pnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ct'on 7 00) of Division 3 of the Business and P 0 ode, a_ np my license is in full force
an&%fctt. ^•. Uy
License Class .... License No Date y 7 Contractor Signature
CORKERS' COV1P0NSATION DECLARATION
NARNINGw: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE THO AND DOLLARS ($100,000), IN ADDITION TO THE
W41biityOMPENSAj,TION, pAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
of perjury one of the following declarations:
gave and swill 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
nance oftne work for which this permit is issued. Policy No.
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'
carrier and policy number are:
ie of Agent
certify that, in the p
if I should become
of
Policy Number
Date
Ice o th r for which this permit is issued, I shall not employ any person in any manner so as to become subje o the workers' compensation laws of California, and
to th ork 'ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p isions/r/ / I
n.r [� / Y
CLARATION REG DIN CO TRLICTION LENDING AGENCY I (
Ireby affirm under enalty kf p ury that 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 onthe pro owners behalf.
I have read this application and the information I have rove ed is correct.
I agree to comply with all applicable city and coun y ofei
inion es an state laws relating to building construction. /
I authorize representatives of this city or county en the b :15gied property for inspection purposes. i I / d
nature of Pmnertv Owner or Authorized ADent Y CTT Print Propertv Owner's or Authorized Agent's Nam) /p' V
ACTION DATE I `/BY
VCULAI IIV" ur wUmv" vUu Vv' I" a V"c y,
FEDERAL REGULATIONS PART 61 OFTDIE40AND
AQMD RULE 1403.
PERMfTEXPIREO
❑ I SUBMITTEDASBESTOS AmTIFICATTON TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS N07IRCAITOMIS NOT APPLICABLE TO
PROPOSED DEMOLITION
PERMITFINAL s7 /
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED
Date
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