HomeMy WebLinkAboutf2022-0221 - PermitsCity of Newport Beach - Building Division III�IIIIIII�III�I�IIII�I�NI��������� II FIRE Permit: F2022-0221
3 100 Civic Center Drive, Newport Beach, CA 92660 II Project NO : 1090-2022
4i Permit Counter Phone (949)644-3288
s:
a,eP. Inspection Requests Phone (949)644-3255
Job Address: 633 LIDO PARK DR NB St: 1 Ft: 3 Unit: E-3
Description: MFR FIRE SPRINKLER 5 HEADS (X2022-0465)
Inspector Area: r In Q�
Legal
Description:
TR 8094 LOT 1 UNIT 6 BALCONY 6-B PATIO 6-C PARKING 6-P OF
PROJECT Y t
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Owner: MACDONALD RICHARD & CLAIRE
Contractor:
STEPHEN CUCULIC FIRE PROT Architect:
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Address: 633 LIDO PARK E3
Address:
33041 CALLE PERFECTO Address:
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NEWPORT BEACH, CA 92660
SAN JUAN CAPISTRANO, CA 92675
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Phone:
Phone:
714-608-1175 Phone:
State Lic:
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Applicant: STEPHEN CUCULIC FIRE PROT
Con State Lie:
954483 Engineer:
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Address: 33041 CALLE PERFECTO
Lie Expire:
11/30/2022 Address:
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SAN JUAN CAPISTRANO, CA 92675
Bus Lie:
BT30072160
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Phone: 714-608-1175
Lie Exp Date:.
06/3012022 Phone:
State Lie:
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Code Edit: 2019
Workers
Compensation
Insurance Designer:
CUCULIC STEPHEN
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Type of Construction: V-A- SPR
Carrier:
NO EMPLOYEES Address:
33041 CALLE PERFECTO
Occupancy Group: R2/11
Policy No:
SAN JUAN CAPISTRANO, CA 9*1§ •
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Added /New sq.ft. Bldg: 0
Expire:
Phone:
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Added/New sq. ft. Garage: 0
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No of Stories: 3
Issued
Date: 04/25/2022 Special Conditions:
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No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: N
Left:
Right:
FEES
Construction Valuation: $750.00
Building PC Fee,
$222.00
Fire Residential Alarm PC Fee : $0.00
Records Management:
$2.00
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
Fire Permit as :
$0.00
Public Works Traffic Plan Check Fee; $0.00
Building Permit Fee:
$269.00
TOTAL FEE :
$493.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance :
$493.00
PROCESSED BY:
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OTHER DEPARTMENT:
ZONING APPROVAL:
PLAN CHECKED BY::
FIRE APPROVAL:
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APPROVAL TO ISSUE:
I
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 civic 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 U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7644,
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-Builderwill have the burden of proving that it was not built or
improved 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).
I am exemp;fjgru licensure under the Contractors' State License Law for the following reason:
By my signature be local 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 legalh
sell a structure tfiati Dave 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
R'ofLS ions COM-• available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.html.
signature of Proper"wner or Authorized Agent Date
LYGENSED CONTRACTOR'S DECLARATION
I hereby affirm wader penalty of perjury that I am licensed under provisions of Chapter 9 (commencing witp Section 7000) of Division 3 of the Business a Professions Code, and my license is in full force
pAq eRgct.
License Class License No Date '1 2S Contractor Signet,
W6R�RS' P10?4Pl!NSATION DECLARATION
NARMNG: FAILURE TQ SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE H NDRED THOUSAND DOLLARS ($100,0001, IN ADDITION To THE
gg4TAIFCOMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
4h0reblP,affirm ur % pa'nalty of perjury one of the following declarations:
••4trave and 11l Vintain 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
aarfoimance of4he work forwhich this permit is issued. Policy No.
have 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' compensatiol
rance carrier and policy number are:
of Agent
Policy Number Expiration Date
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
become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r
rfgnatureofAppli'ah Dat :9
IECLARATION REG R STRUCTION LENDING AGENCY
hereby affirm under enalty of perjury that there is a construction lending agency for the performance of the work for which this permit is is a (Section 3097, Civil Code).
.ender's Name Lender's Address
ly my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners 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 authorize representatives of this city or county t/ enter the above -identified property for inspection purposes. n ,
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF T17LE40 AND
AQMD RULE 1403
PERMITEXPRED
❑ 1 SUBMITTEDASBESTOS NOTIFICATIONTO.,
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CER7IFICATEOF
SIGNATURE:.
OCCUPANCYISSUED