HomeMy WebLinkAboutF2021-0468 - Permitsxvo� City of Newport Beach - Building Division IIIII�IIIIIIIIIIIIIII�IIIIIIIIII�I II
J e L 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 4 6 8
Permit Counter Phone (949)644-3288
E/slrn3�a:
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
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
TOTALFEE
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
$7,000.00
FIRE Permit: F2021-0468
Project No: 2352-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS 42 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:
04/30/2022
Bus Lic:
BT30046886
Lic Exp Date:
0413012022
Worker's Compensation Insurance
Carrier:
FALLS LAKE FIRE & CASUALTY
Policy No:
FLA0080008
Expire:
12129/2021
Issued Date: 10/0612021
Setback- Front:
Rear:
Left:
Right:
$222.00
$0.00
$0.00
$0.00
$0.00
$0.00
$269.00
$499.00
FEES
Fire Residential Alarm PC Fee
Planning Counter Review
Planning Zoning PC Fee
Public Works PC Fee
Public Works Traffic Plan Check Fee;
Plan Check Fee:
Architect:
_
Address:
cc
Phone:
State Lic:
Engineer:
Address:
• .. • • •
• •
Phone:
State Lic:
Designer:
FIREGUARD SPRINKLER SYS,
Address:
7907 LEEDS ST
CLa
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DOWNEY, CA 90242
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Phone:
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Special Conditions:
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$0.00 Records Management: $8.00
$0.00
$0.00
$0.00
$0.00 $0.00
$0.00
$0.00
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
Fee Due at Permit Issuance : $499.00
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -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
:lot 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 L) 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).
LI 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 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:hftp://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED C0.gJRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio '700 ) of Division 3 of the Business and Pr fessio s Code, and my license is in full force
6514 effect. ' 0 0. 7 ? j
LicensEPClass'____' License No Date / LI Contractor Signature
4GR11;ERS' COMPENSATION DECLARATION
:URE 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
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:
have and;wl"giintain 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
fiance of the work for which this permit is issued. Policy No.
and wi l 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'
can-464rft1 dolicy number are:
ie of Agent
certify that, in the pa
, if I should become
of
Policy Number
Date
Ice the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the wo
to th wII Vorkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio.ns . r �'
n�ro l
CLARATION REGARDING CWSTRUCTION LENDING AGENCY I
�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
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 pro owner's behalf.
I have read this application and the information I have rovrf!id is correct.
I agree to comply with all applicable city and county or finance and state laws relating to building construction.
I authorize representatives of this city or county to t the ab ve-identified property for inspection purposes.
nature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Name
compensation laws of California, and
Civil Code).
0 Date
ACTION
DATE
DECLARATION OF COMPLIANCE MTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 51 OF T17L.E40 AND
AOMD RULE 9403.
PERMfTEXPfRED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMDD .
PERMIT CANCELLED
PERMfTEXTENDED
ASBESTOS
PROPOSED DEMOLITION.TtON IS NOT APPLICABLE TO
PERMIT FINAL
—( • Z Z
W
CE.RTIFICATEOF
SIGNATURE:
OCCUPANCYI5SUED