HomeMy WebLinkAboutF2019-0056 - Permits (2)4w1 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II FIRE Permit: F2019-0056
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 9 0 0 5 6 Project No : 0242-2019
N Permit Counter Phone (949)644-3288
Inspection Requests Phone(949)644-3255
Job Address: 4701 SURREY DR NB Description: SFR FIRE SPRINKLERS (48 HEADS) X2018-0177
Inspector Area:.5
Owner:
PLEASANTVILLE RD PTRS
Address:
1 CORPORATE PLAZA DR #110..
Contractor:
NEWPORT BEACH CA 92660
Phone:
1k f�10iR
C T, 0
Applicant:
FIREGUARD SPRINKLER SYS INC
Address:
9543 VICTORIA AVE
Construction Valuation:
SOUTH GATE CA 90280
Phone:
714-310-0194
Code Edit: 2016
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
R31U
0
0
Legal Description:
N TR 3519 LOT 67
Contractor:
FIREGUARD SPRINKLER SYS INC
Architect:
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Address:
9543 VICTORIA AVE
Address:
•° •°°
Construction Valuation:
SOUTH GATE CA 90280
Phone:
714-310-0194
Phone:
State Lic:
Con State Lic:
-992002
Engineer:
Lic Expire:
04/30/2020
Address:
$0.00
Bus Lic:
ST30046886
Building Extention Fee :
$0.00.
Lic Exp Date:
04/3012019.
Phone:
State Lic:
Worker's Compensation Insurance
Designer:
VO JOHN
Carrier:
FALLS LAKE FIRE & CASUALTY
Address:
526 N SHADYDALE AVE
Policy No:
FLA0080008
$0.00
WEST COVINA CA 91790
Expire:
12129/2019
Phone:
Public Works Traffic Plan Check Fee;
1 Issued Date: 01129/2019
0 Setback- Front:
Rear:
Y Left:
Right:
Special Conditions:
.o.o
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL :
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE: `--�
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
oo.mow
FEES
•
•° •°°
Construction Valuation:
$8,000.00
Building PC Fee :
$202.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
. . f4.00
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
o... $10.00
a ° "
Fire Permit Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00.
•
....,.
Building Permit Fee :
$240.00
°
TOTAL FEE :
$446.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$446.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL :
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE: `--�
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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
is 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
'rofessions 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
of more than five hundred dollars ($500).
7 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,
lusiness 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
nprovements 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
nproved for the purpose of sale).
11, 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
pply 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:
ly 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•,
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (comme clog with Se tion 70 0) of Division 3 of the Business and Prof Sion Co e, rod my license is in full force
nd effect.
!cense Class License No i S Contract, i nature
VORKERS' COMPENSATION DECLARATION
DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST 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:
7 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 the
erformance of the work for which this permit is issued. Policy No.
have and wil& oriajrJtain 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'
rhe carrieljap(j pClicy number are:
ier ' Policy Number Expiration Date
?Agent"""
Ify that, in the performar of he 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
should bscona�subject t the ork_ ers' c pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision. /2%/
. IVB/ --'� 1/^
?e of A�is'ant' (� �e
AIK14-REPAIZDING"COMBRUCTION LENDING AGENCY
affirm uRder penally of perjury that there is a construction lending agency for the performance of the work for which this permit
Name . Lender's Address
y iriy 4gnature below,) certify to each of the following:
I am' the pri!aeWdlivner or authorized to act on the property owner's behalf.
'riffle read tills application and the information I provided is correct.
"N 1gree to dbpl*.,Lith all applicable city and cou ty o inances///and state laws relating to building construction.
I authorize representatives of this city or countyente thl a; b g -identified property for inspection purposes.
innature of Pronerty w9nPwArYGTthorized Anent __ . , / d� Print ProDertv Owner's or
(Section 3097, Civil Code).
A
ACTION DATE k—/ BY
DECLARATION OF CUMPLiANCLYYI1 HCOUlfOt
FOR OFFICE U51154M Y'
FEDERAL REGULATIONS PART Of OF TITLE40AIVD
AQMDRULE 9403.
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SIGNATURE:
OCCUPANCVISSUED
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