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HomeMy WebLinkAboutF2022-0252 - Permitsa"''rrr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2022-0252 .� _ r% 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 2 5 2 Project No : 1284-2022 w ' n. Permit Counter Phone (949)644-3288 � < � � Inspection Requests Phone (949)644-3255 ����YalYT�4. Job Address: 127 G ST NB Description: SFR FIRE SPRINKLERS (29) HEADS (X2021-1645) REVISED Inspector Area: 1 Legal Description: N TR 518 BLK A LOT 2 Owner: MCCUNE DANA & MYRNA Contractor: FIREGUARD SPRINKLER SYS INC Architect: Address: 4277 OAKWOOD AVE Address: 7907 LEEDS ST Address: LA CANADA CA 91011 DOWNEY CA 90242 Phone: Phone: 714-310-0194 Phone: State Lic: Applicant: VO JOHN Con State Lic: 992002 Engineer: Address: 526 N SHADYDALE AVE Lic Expire: 04/30/2024 Address: WEST COVINA CA 91790 Bus Lic: 78648 Phone: 714-310-0194 Lic Exp Date: 04/3012023 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: VO JOHN Type of Construction: V-B-SPR Carrier: FALLS LAKE FIRE & CASUALTY Address: 526 N SHADYDALE AVE Occupancy Group: R3/U Policy No: FLA0080008 WEST COVINA CA 91790 Added /New sq.ft. Bldg: 0 Expire: 12/29/2022 Phone: 714-310-0194 Added /New sq. ft. Garage: 0 No of Stories: 3 Issued Date: 0511612022 Special Conditions: No of Units : 0 Setback- Front: Flood Zone. X Rear: Bldg Sprinklers: Y Left: Right: FEES Construction Valuation: $6,000.00 Building PC Fee : $222.00 Fire Residential Alarm PC Fee : $0.00 Records Management : $4.00 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 $0.00 $0.00 Fire Plan Check Fee: $0.00 Public Works PC Fee : Fire Permit Fee : $0.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $269.00 ' TOTAL FEE : $495.90 Plan Check Fee : $495.00 Fee Due at Permit Issuance : $0.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: .. 'A,PPRO\AL-0:SSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 :he 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 Iicensure 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 rot 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). Ll 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 Iicensure 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 legally 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://www.leginfo.ca.gov/calaw.html. 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 Sectio 700') of Division 3 of the Business and P fess'ons Code, and my license is in full force and effect. n License Class License No Date 1� Contractor Sign WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE us DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, 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 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 Wince of the work for which this permit is issued. Policy No. have and will maintain workers' car rance carrier a9d'Mlicy number are: of Agent insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Date JI certify that, in the performance f 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 agree iat, if I should become subje at �7 a wo ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those I Iignature of Applicant DateX I/// IECLARATION REGAR G CON U TION LENDING AGENCY TAT^ hereby affirm under pen Ity of perjury t there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address ly my signature below, I certify to each of the following: am the property owner or authorized to act on the grope o ner's behalf. I have read this application and the information I have pr ided 's correct. I agree to comply with all applicable city and county ordi antes nd state laws relating to building construction. 1 authorize representatives of this city or county to trite a abo -identified property for inspection purposes. AC77ON DATE BW DECLARATION OF COMPLIANCE KITHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NODFICATION TO: ❑ EPA ❑ ACMD _ PERMITCANCELLED PERMIT EXTENDED ASBES MS NOTIRCAT:OI: IS NOT APPLICABLE TO PkOPOSEu DE 0LJTION. PERMIT FINAL CERAFICATEOF SIGNATURE: OCCUPANCYISSUED . �,wir�g, City of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII II FIRE Permit: F2022-0252 o�„ rx 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1284-2022 �, Permit Counter Phone (949)644-3288 r, cIr art> � Inspection Requests Phone (949)644-3255 Job Address: 127 G ST NB Description: SFR FIRE SPRINKLERS (27) HEADS (X2021-1645) z Inspector Area: 1 Legal Description: N TR 518 BILK A LOT 2 01 Owner: MCCUNE DANA & MYRNA Contractor: FIREGUARD SPRINKLER SYS INC Architect: WU Address: 4277 OAKWOOD AVE Address: 7907 LEEDS ST Address: LA CANADA CA 91011 DOWNEY CA 90242 State Lic: Phone: Phone: 714-310-0194 Phone: Applicant: VO JOHN Con State Lic: 992002 Engineer: 1. J Address: 526 N SHADYDALE AVE Lic Expire: 04/30/2024 Address: WEST COVINA CA 91790 Bus Lic: 78648 State Lic: �°� Phone: 714-310-0194 Lic Exp Date: 0413012023 Phone: �,,,! Code Edit: 2019 Worker's Compensation Insurance Designer: VO JOHN Type of Construction: V-B-SPR Carrier: FALLS LAKE FIRE & CASUALTY Address: 526 N SHADYDALE AVE Occupancy Group: R3/U Policy No: FLA008000B WEST COVINA CA 91790 - Added /New sq.ft. Bldg: 0 Expire: 12/29/2022 Phone: 714-310-0194 Added /New sq. ft. Garage: 0 No of Stories: 3 Issued Date: 0511612022 Special Conditions: No of Units : 0 Setback- Front: Flood Zone: X Rear: Bldg Sprinklers: Y Left: Right: FEES Construction Valuation: $6,000.00 Building PC Fee : $222.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $4.00 Building Overtime PC Fee: $0.00 Planning Counter Review: $0.00 Building Extention Fee : $0.00 Planning Zoning PC Fee : $0.00 $0.00 Building Investigation Fee : $0.00 $0.00 Public Works PC Fee : $0.00 $0.00 Fire Plan Check Fee: Fire Permit Fee : $0.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee : $269.00 TOTAL FEE : $495.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $495.00 PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: CTHER,DF.Pf.R-MENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: (� PERMIT EXPIRES 180 DAYS PETER ISSbAhCE OR�LAS'P VALID INSPECTION DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason (a) 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 ie 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 'rofessions 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 of more than five hundred dollars ($500). 1 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, lusiness 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 nprovements 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 nproved for the purpose of sale). 7 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 pply 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: ly 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 legall, ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. 'signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjurythat I am licensed under provisions of Chapter 9 (commencing with S o 700 ) of Division 3 of the Business and Pro ssion de d my license is in full force nd effect. icense Class License No Date 2 Contractor Signatur VORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED IYOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 Pfmance of the work for which this permit is issued. Policy No. have and 41 m �kItain workers',ceNensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensa ie of Agent certify that, in the pertorman e of , if I should become subRct tithe of Date 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 npensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Y nWl A7/iG,/2Z CLARATION REGAFIRG CQI(1STF�hUCTION LENDING AGENCY I :reby affirm under p natty of pe lI hat 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 propeAcesan winehalf. I have read this application and the information I have proadrect. I agree to comply with all applicable city and county ordinto aws relating to building construction. I authorize representatives of this city or county to en r tdroperty for inspection purposes.nature of PropertOwner or Authorized Agent Print Property Owner's or Authorized Agent's NameX ACTION DATE 8Y DECLARATION OF COMPLIANCE WITH CODEOF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQAD ROL E_ 94Q. 1.:UBf11 TT-�D ASBESTOS NOTIFICATION TO: ❑ -7pA ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE' FOR OFFICE USE ONLY PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL _ B CERTIFICATEOF OCCUPANCYISSUED