HomeMy WebLinkAboutF2021-0081 - PermitsCity of Newport Beach - Building Division "F2021-0081'
A
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
IN I CZ
M7:
Job Address: 20171 BAY VIEW AVE NB
Inspector Area: 3
Owner: FARAH FARHAD TRF FARAH SEP TR
Address: 3366 FUCHSIA ST
COSTA MESA, CA 92626
Phone:
Applicant: MORENO EDUARDO
Address: 28568 LANTERN PARK LN
MENIFEE CA 92584
Phone: 951-274-0734
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:
1
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
FIRE Permit: F2021-0081
Project No : 0486-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS (32 HEADS) X2021-0081
Legal Description:
N TR 1507 LOT 9
Contractor:
LSE FIRE PROTECTION INC
Architect:
Address:
28568 LANTERN PARK LANE
Address:
MENIFEE, CA 92584
Phone:
951-274-0734
Phone:
State Lic:
Con State Lic:
950739
Engineer:
Lic Expire:
1113012023
Address:
Bus Lic:
BT30074578
Lic Exp Date:
03/3112022
Phone:
State Lic:
Worker's Compensation
Insurance
Designer:
MORENO EDUARDO
Carrier:
FALLS LAKE FIRE & CASUALTY CO
Address:
28568 LANTERN PARK LN
Policy No:
FLA01207000
MENIFEE CA 92584
Expire:
07/21/2022
Phone:
951-274-0734
Issued Date: 03/24/2022
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
FEES
Construction Valuation:
$3,000.00
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 :
$68.00
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 :
$561.00
Plan Check Fee :
$217.00 Fee Due at Permit Issuance :
$344.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
J
-5G
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 L) 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).
❑ 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).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
,By my signature baicN 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 legally
sell a s�ructurc 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 C,r'e, IE available upon request when this application is submitted or at the following Web site: http://www. leginfo. ca.gov/calaw.html.
„Signab ire of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I herehy 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
ono effect
.:.;se Class _ License No Date Contractor Signature
AORKERS' COMPENSATION DECLARATION
4A.M.L.G: 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 (6100,000), IN ADDITION TO THE
COST f IF COMPENSATUI:, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm d.ider penalty of perjury one of the following declarations:
❑ ; 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
erformance di the work for which 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' compensaticr
insurance carrier and policy number are:
Policy Number Expiration Date
IS of Agent ?p f f if OVI j rnone F
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,-wn[kacompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lature of Applicant IX/Iz? Date -C
: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 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 abo/v�,-icl ti_fied property for inspection purposes.
nature of Property Owner or Authorized Agent X Print Property Owner's or Authorized Agent's Name °
Civil Code).
AC77ON
DATE
BY
DECLARATIONOF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF T17LE 40 AND
AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS N077FICATION TO:
❑ EPA
❑ AQMD
PERMIT EXPf RED
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIFiCATEOF
SIGNATURE:
OCCUPANCYISSUED