HomeMy WebLinkAboutF2019-0234 - Permitsdew City of Newport Beach Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2019-0234
Q 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 9 0 2 3 4
Project No: 0874-2019
Permit Counter Phone (949)644-3288
9tet'" Inspection Requests Phone (949)644-3255
Job Address: 20051 BIRCH ST NB
Description: COMM FIRE ALARM SYSTEM - 48 DEVICES
Inspector Area: FIRE
Legal Description:
TR 706 LOT 84 EX SWLY 112 & EX NWLY 165 FT
Owner: SDW REAL ESTATE HOLDINGS LLC
Contractor:
RIVERSIDE SYSTEM DESIGNS INC
Architect:
Address: 22051 SW BIRCH ST
Address:
2023 CHICAGO AVE#B16
Address:
NEWPORT BEACH CA 90660
Planning Counter Review:
RIVERSIDE CA .92607
Building Extention Fee:
Phone:
` Phone:
909.578.8050
Phone:
Applicant: PHAM YOUNG
Con State Lic:
973373
Engineer:
- Address: 2023 CHICAGO AV STE B16
Lic Expire:
05/3112020
-. Address:
RIVERSIDE CA 92507
Bus Lic:.
BT30069660
Building Permit Fee :
Phone: 951-684-3858
Lic Exp Date:
06130/2020
Phone:
Code Edit: 2016
Worker's Compensation
Insurance
Designer:
Type of Construction: V-A- SPR
Carrier:
MID-CENTURY INS
Address:
Occupancy Group: 'B
Policy No:
A09496614
Added /New sq.ft. Bldg: 0
Expire.
06/17/2020 -
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 3
Issued Date: 0912612019
Special Conditions:
' No of Units : 0.
Setback- Front:
.Flood Zone: X
Rear:
Bldg Sprinklers: - Y
: Left:
Right
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
$0.00
$0.00
$0.00
$0.00
$0.00
State Lic. {
;j
State Lic4
PHAM YOUNG
2023 CHICAGO
RIVERSIDE CA 92507
909-518-8000
Records Management :
$263.00 Fee Due at Permit Issuance
C
OTHER DEPARTMENT:
" °- ° �, ° q•. ` ' PLASoCHECKED BY::
APOROVAL TO ISSUE:
PERMIT EXPIRES 580 DAi S M F 1,3SVJANCE OR LAST VALID INSPECT10h
$4.00
$0.00
$0.00
$368.00
FEES
Construction Valuation:
$10,000.00
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee
Building Overtime PC Fee:.
$0.00
Planning Counter Review:
Building Extention Fee:
$0.00.
Planning Zoning PC Fee
Building Investigation Fee:
$0.00
Fire Plan Check Fee: -
$283.00
Public Works PC Fee:
Fire Permit Fee :.
$364.00
Public Works Traffic Plan Check Fee;
Building Permit Fee :
$0.00
-
TOTAL FEE i
$651.00
Plan Check Fee
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
$0.00
$0.00
$0.00
$0.00
$0.00
State Lic. {
;j
State Lic4
PHAM YOUNG
2023 CHICAGO
RIVERSIDE CA 92507
909-518-8000
Records Management :
$263.00 Fee Due at Permit Issuance
C
OTHER DEPARTMENT:
" °- ° �, ° q•. ` ' PLASoCHECKED BY::
APOROVAL TO ISSUE:
PERMIT EXPIRES 580 DAi S M F 1,3SVJANCE OR LAST VALID INSPECT10h
$4.00
$0.00
$0.00
$368.00
LDER 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 doe-
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 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:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent ate
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti n 7000 of Division 3 of the Business an ro s ons Code, and my license is in full force
and effect.
License Class License No Date Contractor Signatur
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO E HU ED THOUS ND DOL 1$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:
-11 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 the
Derformance of the work for which this permit is issued. Policy No.
Pt'have and will m 'ain 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
nsurance carrier an Doll6y number are: ^
farrier \ 01 Cy�r�ber Expiration Date
Vame of Agent r Phone #
❑I certify that, in the performan the 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 agree
:hat, if should become subleq o e workers' compensationpwvisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applican — Da +
CLARATION RE G STRUCTION LENDING AGENCY
ireby affirm uncle al of perjury 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:
1 am the property. owner or authorized to act on the Vrdi
roertgwner's behalf.
1 have read this application and the information I hed is correct.
I agree to comply with all applicable city and couas and state laws relating to building construction. VOU
I authorize representatives of this city or countyabove-identified property for inspection purposes./ f/ ��1- Anature of Pmnertv Owner nrAuthorized ADent /�-- Print Prooertv Owner's or Authorized Agent's Name NIDI '[ � t \
AC77ON I DATE
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