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HomeMy WebLinkAboutF2018-0299 - PermitsrD City of Newport Beach - Building Division IIIIIIIIIIIIIIillillIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII jl FIRE Permit: F2018-0299 a� 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 8 0 2 9 9 Project No: 1202-2018 N Permit Counter Phone (949)644-3288 9) -^,° v�s> ` Inspection Requests Phone (949)644-3255 Job Address: 435 SAN BERNARDINO AVE NB Description: SFR FIRE SPRINKLERS (X2017-3229) 49 HEADS Inspector Area: 2 Legal Description: FIRST ADD TO NEWPORT HEIGHTS BILK 13 LOT 15 Owner: PALLEY MARION Contractor: FIREGUARD SPRINKLER SYS INC Architect: Address: 435 SAN BERNARDINO AVE Address: 9543 VICTORIA AVE Address: NEWPORT BEACH, CA 92663 SOUTH GATE CA 90280 Phone: Phone: 714-310-0194 Phone: State Lie: �. Applicant: VO JOHN Con State Lic: 992002 Engineer: Address: 526 W SHADYDALE AV Lic Expire: 04/3012020 Address:''`" WEST COVINA CA 91790 Bus Lic: BT30046886 Phone: 714-310-0194 Lic Exp Date: 0 413 012 01 9 Phone: State Lic: Code Edit: 0 Worker's Compensation Insurance Designer: VO JOHN Type of Construction: V-BSPR Carrier: FALLS LAKE FIRE & CASUALTY Address: 526 W SHADYDALE AVE Occupancy Group: 2016 Policy No: FLA0080008-00 WEST COVINA CA 91790 Added /New sq.ft. Bldg: 0 Expire: 12129/2018 Phone: .714-310-0194 Added /New sq. ft. Garage: 0 No of Stories: 2 Issued Date: 05121/2018 Special Conditions: No of Units : 0 Setback- Front: Flood Zone: Rear: Bldg Sprinklers: Y Left: Right: FEES Construction Valuation: $7,000.00 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: ° . • •QTHER DEPARTMENT: 6G® B 6°O e e ° e • ZONING APPROVAL: °• ° ° o • ° o ° eXAN CHECKED BY:: ° °® FIRE APPROVAL: °•° °`° APPROVAL TO ISSUE: PERMIT EXP/RES 18@ DAY'S AISSUAIEC4 OR LAST VALID INSPECTION 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 im roved for the purpose of sale). 1, 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 legall) 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:hftp://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 Sectio 7000 of Division 3 of the Business and Professns ode,my license is in full force and effect. I�/ License Class-. - License No DJVP Contractor Signature NORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU ND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th )erf ance of th rk for which this permit is issued. Policy No. have and wi main in workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol surance carrier d po'cy number are: 3arrier Policy N ber Expiration Date Vame of Agent i Phone # ❑1 certify that, in the performance f t work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre :hat, if I should become sypject to t e w kers' coppensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. f_ nature of Applicant Dat r V CLARATION REG9RDING CONSTRUPTION LENDING AGENCY areby affirm under penalty of perju th t there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097, Civil Code). Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the prope owner's behalf. I have read this application and the information I have prvi d is correct. I agree to comply with all applicable city and county ordi anc s and state laws relating to building construction. I authorize representatives of this city or countyto to the a ove-I entified property for inspection purposes. I{- nature of Prooertv Owner or Authorized ADent V Print Property Owner's or Authorized Agent's Name w( v1 Ua ACTION DATE ly$Y ,WIT air wirvru�awa,a:.vn e a.vu�v FEDERAL $EGlfjjLATIONSPART 67 OFTITLE40AND P€RMITEXPIRED AQMO RULE.T4d!%• • • • • • ❑ I SUIT MATECIASBEStOS AMFJCA11GIN.7%- PERMdTCANCELLED ❑ •EPA�• .• � • • ••• : � PERMITEUENDED 13AQMO • ••: ❑ ASBESTOS NORRCATIONIS NOT APPLICABLE TO PEttMITFtNAt 1 PROPOSEQ[iEj}fQ,PTfON. 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