HomeMy WebLinkAboutF2021-0073 - PermitsCity of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111
G 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 0 0 7 3
Permit Counter Phone (949)644-3288
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Job Address: 3811 RIVER AVE NB
Inspector Area: 1
Owner:
BARRETTJEFF
Address:
3811 RIVER AVE
NEWPORT BEACH, CA 92663
Phone:
714-366-9020
Applicant:
GUTIERREZ RUBI
Address:
8085 E CRYSTAL DR
ANAHEIM, CA 92807
Phone:
714-666-8450
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:
Bldg Sprinklers:
N
FIRE Permit: F2021-0073
Project No: 0449-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLER SYSTEM 23 HEADS (X2018-1919)
Legal Description:
RIVER SECTION BLK 138 LOT 8
Contractor:
RESIDENTIAL FIRE SYSTEMS INC
Architect:
Address:
8085 E CRYSTAL DR
Address:
ANAHEIM CA 92807
Phone:
714-666-8450
Phone:
Con State Lie:
786965
Engineer:
Lie Expire:
11/3012022
Address:
Bus Lie:
BT30003809
Lie Exp Date:
0413012021
Phone:
INZJ&EC '(�,9
State Lie:
0
State Lie: -
Worker's Compensation Insurance
Designer:
GUTIERREZ RUBI o o e
Carrier: CYPRESS INS. CO.
Address:
8085 E CRYSTAL DR 7. .. „
Policy No: REWC019434
ANAHEIM, CA 92807
Expire: 09101/2021
Phone:
714-666-8450 .. ..
Issued Date: 0310212021
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
FEES
Construction Valuation:
$6,456.00
Building PC Fee :
$217.00
Fire Residential Alarm PC Fee :
$0.00 Records Management :
$0.00
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,
$263.00
TOTAL FEE :
$480.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$480.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
o APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
LDER 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
not 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,
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).
❑ 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).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature bcicv. ' 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 legally
sell a structure than I heve 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
Prc`es onS Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Ov.ner or Authorized Agent Date
L IGF.NO3ED 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 a d rofessioonns Co e, n y Ii rise is in full force
any effect.
L�cense Ulass License No Date -3 2 Contractor Signature
V.'O'2YERS' COMPEHSATION DECLARATION
W VWI'1C: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU9.IECT 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 LA9oR CODE, INTEREST, AND ATTORNEY'S FEES.
10elaby .affirm umier 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 thl
performance of th3 wort- for which this permit is issued. Policy No.
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'
carrier and policy number are:
ie of Agent
certify that, in the erf rmancf
if I should becom s bject to
lature of Applicant
Policy Number
Date
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
he Workers' coyp.@n on provie of Section
-3700 of the Labor Code, I shall forthwith comply with those gryvisions.
ereby 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 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 c unty ordinances and Ste laws relating to building construction.
I authorize representatives of this city or cou4 tWty-ttWabolFj nt'IW-property for inspection purposes.
of Property Owner
or Authorized Agent's Name
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TI TLE40 AND
AQMDRULE 1403.
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:.
❑ EPA
❑ AQMD
PERMIT CANCELLED
➢ERMIT EXTENDED
❑ ASBESTOS NOTIFICAIION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED
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