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Home My WebLink AboutF2020-0438 - PermitsCity of Newport Beach - Building Division k 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 205 CANAL ST NB Inspector Area: 3 Owner: V MOELLENHOFF LIVI DAVID Address: 205 CANAL ST NEWPORT BEACH, CA 92663 Phone: Applicant: VO JOHN Address: 526 N SHADYDALE AVE WEST COVINA CA 91790 Phone: 714-310-0194 Code Edit: 2019 Type of Construction: V-BSPR Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 0 Flood Zone: Bldg Sprinklers: N Construction Valuation Building PC Fee : Building Overtime PC Fee: Building Extention Fee: Building Investigation Fee: Fire Plan Check Fee: Fire Permit Fee : Building Permit Fee: TOTAL PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: $5,000.00 llp�F 2 0 2 00��►4 3 8�� II FIRE Permit: F2020-0438 Project No: 2013-2020 Inspection Requests Phone (949)644-3255 INSPECTOR State Lie: State Lic: Worker's Compensation Insurance Description: SFR - FIRE SPRINKLERS 23 HEADS (X202-2472) VO JOHN 2013-2020 Address: Legal Description: N TR 772 BLK 11 LOT 3 Planning Zoning PC Fee : Contractor: FIREGUARD SPRINKLER SYS INC Architect: Address: 9543 VICTORIA AVE Address: $0.00 SOUTH GATE CA 90280 Public Works Traffic Plan Check Fee; Phone: 714-310-0194 Phone: Con State Lie: 992002 Engineer: Lie Expire: 04130/2022 Address: Bus Lie: BT30046886 Lie Exp Date: 04130/2021 Phone: INSPECTOR State Lie: State Lic: Worker's Compensation Insurance Designer: VO JOHN Carrier: FALLS LAKE FIRE & CASUALTY Address: 526 N SHADYDALE AVE Policy No: FLA0080008 Planning Zoning PC Fee : WEST COVINA CA 91790 Expire: 12129/2020 Phone: 714-310.0194 Issued Date: Special Conditions: $0.00 Setback- Front: Public Works Traffic Plan Check Fee; $0.00 Rear: Left: Right: Plan Check Fee: $0.00 F Due at P mit Issuance: FEES $217.00 - Fire Residential Alarm PC Fee: $0.00 Records Management $0.00 Planning Counter Review: $0.00 $0.00 Planning Zoning PC Fee : $0.00 $0.00 $0.00 Public Works PC Fee: $0.00 $0.00 Public Works Traffic Plan Check Fee; $0.00 $263.00 6484.00 Plan Check Fee: $0.00 F Due at P mit Issuance: OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION cmmm $4.00 $0.00 $0.00 $484.00 o r m e•ecn O (. 0 m n 0 o c om n oo•oo„ 0 000uo Om04U0 m o 0 o � UOO�OJ 1NER-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) fiction 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 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 ifessions 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 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, :iness 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 movements 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 moved 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 )ly 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: 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 Iegallt 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 ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Property Owner or Authorized Agent Date TENSED CONTRACTOR'S DECLARATION naby affirm �4rjefp0nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with do 70 0) of Division 3 of the Business and Prof salons Code, and my license is in full force I effect. 14geclass . . License No Date ✓ a Contractor Signature )RARS' 66MPENSATION DECLARATION vour. FAILURE TA SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001, IN ADDITION TO THE WOF COMPENSP4TIT DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. :.reb,affirm unigl&6REnalty 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 the 19t gnce of jhgN{gIR for which this permit is issued. Policy No. 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' ler and policy number are: ..0. Policy Number Expiration Dale certify that, inthe• performan a of a work for ��ryryhich 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 if I should become subject the orkers'Igompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pjg�isionst natureof Applicant � vv � v CLARATION REGAR ING COPSTOUCTION LENDING AGENCY :reby 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). 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 propert wner's behalf. I have read this application and the information I have pro fide 's correct. I agree to comply with all applicable city and county ordina ces d state laws relating to building construction. I authorize representatives of this city or county to r th abov identified property for inspection purposes. ,y nature of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's Name _ _ V ACTION DATE BY DECLARATION OF COMPLIANCE MTN CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403: PERM/t'.EXPIREO ❑ / SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMO ❑ ASBESTOS NORITCAT10NI5NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITCA.NCELLED PERMIT. EXTENDED PERMIT FINAL CERTIFICATEOF SIGNATURE. OCCUPANCYISSUED