HomeMy WebLinkAboutF2021-0468 - Permits (2)City of Newport Beach - Building Division IIIII�IIII�IIIIIIIIIII�I'IIIIIIIIIIIII II
+; ~ 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 4 6 8
Permit Counter Phone (949)644-3288
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Job Address: 1224 DEVON LN NB
Inspector Area: 3
Owner: HOROWITZ TRACY&ERIC
Address: 1224 DEVON LN
NEWPORT BEACH, CA 92660
Phone:
Applicant:. FIREGUARD SPRINKLER SYS INC
Address: 7907 LEEDS ST
DOWNEY CA 90242
Phone: 714-310-0194
Code Edit : 2019
Type of Construction:
V-B-SPR
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:
X
Bldg Sprinklers:
Y
FIRE Permit: F2021-0468
Project No : 2352-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS 44 HEADS (X2020-2301)
Legal Description:
N TR 3000 LOT 33
Contractor:
FIREGUARD SPRINKLER SYS INC
Address:
7907 LEEDS ST
DOWNEY CA 90242
Phone:
714-310-0194
Con State Lic:
992002
Lic Expire:
04/3012022
Bus Lic:
BT30046886
Lic Exp Date:
0413012022
Worker's Compensation Insurance
Carrier:
FALLS LAKE FIRE & CASUALTY
Policy No:
FLA0080008
Expire:
1212912021
Issued Date: 10/06/2021
Setback- Front:
Rear:
Left:
Right:
Architect:
Address:
Phone: State Lic
Engineer:
Address:
Phone:
State Lic:
Designer:
FIREGUARD SPRINKLER SYSTEMS
Address:
7907 LEEDS ST
DOWNEY, CA 90242
Phone:
Special Conditions: 1219/21
REVISED # OF HEADS
SET
FEES
Construction Valuation:
$7,000.00
Building PC Fee :
$222.00
Fire Residential Alarm PC Fee :
$0.00 Records Management :
$8.00
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 Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$269.00
TOTAL FEE :
$499.00
Plan Check Fee:
$499.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
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OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PEWIT CF2RES `180 Dvl' Y$ AFTER ISSUANCE OR LAST VALID INSPECTION
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OWNER -BUILDER DECLARATION
1 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 U 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
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
iapply 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 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:// n .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.
License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES.
I hereby affirm under penalty 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
performance of the work forwhich this permit is issued. Policy No.
I 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' compensation
insurance carrier and policy number are:
Policy Number
of Agent
Date
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
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date
CLARATION REGARDING CONSTRUCTION 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:
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 authorize representatives of this city or county to enter the above -identified property for inspection purposes.
nature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Name
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WTH CODE OF
FOR OFFICE US€ ONLY
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