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Home My WebLink AboutF2019-0125 - Permitsaawh�, City of NewpoffBob" ef&upcEingPivision' IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1IIIIIIIIIIIIIIIIII11 Jill FIRE Permit: F2019-0125 a Civic Center Drive, b4ew oryBeaeh, �:A.92�i80 F 2 0 1 9 0 1 2 5 .100 ® Permit Counter Phonee(049)�44*31186° °,°. o•e Project No: 0500-2019 - ;,,` r'a sv��r'> e • ° ° Inspection Requests Phone (949)644-3255. e c oc • c r o.- 0 roc Job Address:. 1004 S BAY FRONT NB Description: SFR FIRE SPRINKLERS 40 HEADS (X2018-0093) Inspector Area:: 2 Legal Description: BALBOA ISLAND SEC 2 BILK 5 LOT Owner: WELKER JAY Contractor: R F P INC Architect Address: ' . 1004 W BAY FRONT Address: ` 7361 HEIL AVE #C Address: - NEWPORT BEACH CA 92662 HUNTINGTON BEACH CA 92647 Phone Phone: 714-842-5630 Phone:' State Lie: Applicant: BALA DAVE : Con State Lie: 911531 Engineer: Address: 7351 HEIL AVUNIT C Lie Expire: 02/2912020 - Address: HUNTINGTON BEACH CA 92647 Bus Lie: ST30049933 Phone: 714-231-0913 Lie Exp Date: 03/31/2020 Phone: State Lic: Code Edit: 2016 Worker's Compensation Insurance : Designer: BALA DAVE Type of Construction: V -B -SPR Carrier:. EVEREST Address: 7351 HEIL AV UNIT C Occupancy Group: R3IU Policy. No: 5300004390 HUNTINGTON BEACH CA 92647 Added /New sq.ft. Bldg: 0 Expire: 07/01/2019 Phone: Added /New. sq. ft. Garage: 0 No of Stories: - 3 Issued Date: 03/07/2019 Special Conditions: No of Units: 0 Setback- Front: Flood Zone: Rear. 'Aa Bldg Sprinklers: Y Left: yws a Right FEES Construction Valuation: $9,900.00 Building PC Fee: $202.00 Fire Residential Alarm PC Fee $0.00 Records Management: ? $6.00 - ' 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 FirePermit Fee : $0.00 Public Works Traffic Plan Check Fee; $0.00 - - Building Permit Fee: $240.00. - TOTAL FEE : $448.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $448.00 PROCESSED BY:. OTHER. DEPARTMENT: ZONING APPROVAL PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: - PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 7WNER-BUILDER DECLARATION • •e e o •• I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated leloow by;h jcljec1mjr4s)J 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, bbr�paic any structure; prior toltSSssuance, 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 applicantto a civil penalty of not more than five hundred dollars ($500), • • :��. .� • ��• ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or.(_j portions of the wmk,and:he 9trucitge (s n`,ot Intentled vrQfferedfor sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employges' or personal Etffdijr builds dfTmproves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year ofcompletion, fib Cider -Builder will have the burden of proving that it wasnot built or Improved 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). ❑ 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 legal) 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 Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. ^r -Z% License Class cj License No Date Contractor Signatu 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 ONE HUNDRED THOUSAND DOLLARS ($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 hereby affirm under penalty of perjury one of the following declarations: I ave 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 3e Trance of the work for which this permit is issued.- Policy No. I ave 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 insu nce carrier and olicy number are: xx 22 vier &4e� ew Policy Number J`�3 '� c-� o�(/ w N Expiration Date 7- ✓' — t-0 / q Name of Agent 7_C7_# Al Phone # M4 ❑I certify that, in the performance of 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 afire that, if I should become subject to the work mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Skmature of ApplicaDT;9� DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty 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). Lender's Name Lender's Address By my signature below, I certify to each of the following: - 1 am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction.. I authorizerepresentatives of this city or county to enter the above= Jed property for inspection purposes. �j. D Signature of Property Owner or Authorized Agent Print PropertyOwner's or Authorized Agent's Name �"/ fe C° �' Date ACTION DATE BY DECLARATION OF COMPLIANCEtMTH CODEOF FOR OFRCE USE ONLY. FEDERAL REGULATIONS PART 61 OF TITLE40ANID PAQMDRULE 1403. ERMITEXPeR€D 1 SUBMITTED ASBESTOS: NOTIFICATION TO. PER FITCANCELLED ❑ EPA P£RMIT EXTEND€D ❑ AQMD ❑ ASBESTOS M017RCAITOMIS .NOT APPLICABLE TO PERMITFINAt ALPROPOSEIDDEMOLITIOM. CER77FfCATEOF ' nrrnDnArrvrccr rcn 1 SIGNATURE:.