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HomeMy WebLinkAboutF2023-0043 - PermitsCity of Newport Beach o�aEWPpRT 0 Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 u fix. Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 CgG�F00.N\P newportbeachca.gov/inspections Combination Type - SFP Work Class - Addition F 2 0 2 3 0 0 4 3II COMB Permit : F2023-0043 Plan Check No: PC2023-0167 Issued Date : 0112612023 Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 552 SEAWARD RD Legal Desc : N TR 1237 BLK LOT 178 TRACT NO 1237 LOT 178 AND TRACT NO 147 95 LOT 4 Description: SFR FIRE SPRINKLERS (6) HEADS X0p2/- jlp'7y Owner: BRYAN ROGERS CALIFORNIA RESIDENCE Contractor: RESIDENTIAL FIRE SYSTEMS INC Architect : TRUST Address: 552 SEAWARD RD CORONA DEL MAR, CA 92625 Phone Applicant: RESIDENTIAL FIRE SYSTEMS INC Address : 8085 E CRYSTAL DR ANAHEIM, CA 92807 Phone: (714)666-8450 Owner/Builder : Address : Phone Code Edition : 2022 Type of Construction : V-B Occupancy Groups: R3/U Bldg Height: Building Setbacks Address : 8085 E CRYSTAL DR ANAHEIM, CA 92807 Phone: (714)666-8450 Con State Lie : 786965 Lie Expire : 11/30/2024 Bus Lie: BT30003809 Bus Lie Expire : 04/30/2023 Workers' Compensation Insurance Carrier: PACIFIC COMPENSATION INS CO Policy No: WA00712001 W. C. Expire : 9/1/2023 Fire Sprinklers : Fire Hazard Zone No of Units : No of Stories Address Phone: State Lie Engineer: Address Phone: Designer: Address Phone : NO Construction Valuation : YES Added/New/TI sq. ft. Bldg 1 Alteration sq. ft. Bldg : Added/New sq. ft. Garage TOTAL sq. ft. : Flood Zone : X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: C�L SPECIAL CONDITIONS: "e !r CTO L- a Ge' $3,502.00 0 0 0 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 :he permit to file a signed statement that ho or she is licensed pursuant to tho 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 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 (_) portions of the work; and the structure Is not intended proffered 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 Coda: The Contractors' State License Law does not apply to an ownerof property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). El 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 tegall sail a structure that I have builtas an owner-buildor if it has not been constructed in its entiroty, by licensed contractors. i understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, isavailable upon request when this application is submitted or at the following Web site:httpJhowvd.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 Section 7000W07�,t �of D�iiv__is�io--n�7 3 of the. Business and Profession en � In full farce and effect. License Class License. No Dat`e�7�[} Contractor Signaturey WORKERS' COMPENSATION DECLARATION l NARNING: 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 (15too,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGPS AS PROVIDED FORM SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perlury, onn of the following declarations: ;it have and will moln,ain 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 to perforrmance of the woo, for which this permit is issued. Policy No. ve 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` compensatiol Plarthance carrier and rol"_y r.Imbe, are: gamier Policy Number Expiration Date dama of Agent _ _ _ Phone # -11 certify that, in the pw ormance of the work for which this permit is issued, I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of California, and agre hat, if I should become sub,act to nL rcnuors' lion visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3ignatureof.Applicant _ _f te,1—Z6-T..� )ECLARATfON RE IN CONS TIO N NG AGENCY hereby affirm under p naity of perlury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Cade). _ender's Name I Lender's Address 3y 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 count to aboI 'de led property for inspection purposes, �G'L�_�/''� Si nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's NamIk KtLY,:.i /pits Z Ddig 7f7-'-3 ACTION DATE BY ( DECLARATIM OF COMPLIANCE WIT4 CODE OF FEDERAL FOR OFFICE USE ONLY I REGULATIONS PART 51 OF TITLE 40 AND AONID RULE. PERMIT EXPNED LI I SUBMITTED ASRESTOS NOTt FICATION TO PERMIT CANCELLED PERMIT EXTENDED /— OMD PCRMIT ASBESTOS NOTlF1CATION 15 N07 APPLICABLE TO CERTIFfCAIEOF / 1 . �(/' PROP0110 fE)fiAElfi tl OCCUPANCYISSUED SIGNATUR /�/%.