The URL can be used to link to this page

Home My WebLink AboutF2018-0628 - Permits (2),r y City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 • Permit Counter Phone (949)644-3288 Illi�FIIIIILII0IIII1IIII8IIIIIInI0I�I6IIIIILII8II II FIRE Permit: F2018-0628 Project No: 2786-2018 Inspection Requests Phone (949)644-3255 Job Address: 504 HAZEL DR NEI Description: SFR FIRE SPRINKLERS (X2017-3225) 28 HEADS Inspector Area: 5 Legal Description: N TR 673 BILK B LOT 36 Owner: 504 HAZEL DRIVE LLC Contractor: FIREGUARD SPRINKLER SYS INC Architect: Address: 504 HAZEL DR Address: 9543 VICTORIA AVE Address: CORONA DEL MAR, CA 92625 SOUTH GATE CA 90280 Phone: Phone: 714-310.0194 Phone: State Lie: Applicant: VO JOHN Can State Lie: 992002 Engineer: Address: 526 N SHADYDALE AV Lie Expire: 04130/2020 Address: WEST COVINA CA 91790 Bus Lia: BT30046886 Phone: 714.310-0194 Lie Exp Date: 04/30/2019 Phone: State Lie: Code Edit : 2016 Worker's Compensation Insurance Designer: Type of Construction: V-BSPR. Carrier: FALLS LAKE FIRE & CASUALTY Address: Occupancy Group: R3/1.1 Policy No: FLA0080008-00 Added /New sq.ft. Bldg: 0 Expire: 12/29/2018 Phone: Added /New sq. H. Garage: 0 No of Stories: 2 Issued Date: Special Conditions: ' No of Units 0 Setback- Front: Flood Zone. Rear: Bldg Sprinklers: Y Left: Right: ° o ° e° FEES JJ ° °GGnsvruction Valuation: $4,000.00 °Joao ° @lIlMing PC Fee i $202.00 Fire Residential Alarm PC Fee : $0.00 Records Management : $4.00 P®ilding O�a rtir€ie PC Fee: $0.00 Planning Counter Review: $0.00 ° e Building E oention° Fee : $0.00 -Planning Zoning PC Fee : $0.00 Efuilding Investigation Fee : $0.00 $0.00 eFi(e Plan Check -Fee: $0.00. Public Works PC Fee: $0.00 $0.00 ° Fire Permit Pee : $0.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee: J��OGCO $240.00 ° p O � TOTAL FEE : $446.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $446.00 \: PROCESSED BY: 1 OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION DWNER-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).. ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 Im roved 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 legally 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 Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with cf n 700 ) of Division 3 of the Busines4NDREDT e, and my license is in full force and effect ��jjj✓✓✓✓// License Class License No Date Contractor Signatu WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C IMINAL PENALTIES AND CIVIL FINES UP TO OOLLARS ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 e imance of the work for which this permit is issued. Policy No. h ve 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' compensatio it nce carrier and policy number are: 'r' r Policy Number Expiration Date — Phone # Tie of Agent �.•�• ooc ti certify that, in the perfo ante f 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 lawl of California, qnd agrci I, if I should become subj ct to t workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ..... o o 0—i Date / 2� I • ° "' nature of Applican o ° CLARATION RE IN CON TRUCTION LENDING AGENCY �� • �' • Ireby affirm under penalty f per' ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). o 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 pr arty owners behalf. I have read this application and the information I he p Vided is correct. Odinces and state laws relating to building construction. ..... I agree to comply with all applicable city and countpnter I authorize representatives of this city or county ve-id ntified property for inspection purposes. / /^ V 6 nature of Property Owner or Authorized A en Print PropertyOwner's or Authorized Agent's Na Date. DATE BY DECLARATION OF COMPLIANCEWITH CODEOF ., FOR OFFICE USE ONLY ACTION FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE -1403. ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA L3 AQMD PERMlT€XPIR€D PERMITCANCELLED PERMIT€7C7'ENDED ❑ ASBESTOS NORRCAPONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED I_ _ C C N a 3. rn sV �" O N V OI C m om �scna Cd A u d ai a (o .d c+j ❑ ❑❑❑ ❑ ❑❑ ❑� I CJ C L3. tU �a y C o rL d w p 6 � W CL {� j E Um CML U. c 12-8 a°�a p .Ll C> 'C v ui 9 O m A °zR ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ a ur a 4I KE E ii h 8 M m H r U �n m � CVCd I I 9 7. } ft1