HomeMy WebLinkAboutF2018-0299 - Permits (2)cmty of Newport Beach - Building Division 111p111111111p111111111111111111111111111111111 Jill
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Job Address: 435 SAN IIERNARDINO AVE NO ® •
Inspector Area: 2
Owner:
PALLEY MARION
Address:
435 SAN BERNARDINO AVE
Occupancy Group:
NEWPORT BEACH, CA 92663
Phone:
0
Applicant:
VO JOHN
Address:
526 W SHADYDALE AV
No of Units :
WEST COVINA CA 91790
Phone:
714.310-0194
Code Edit: 2016
FIRST ADD TO NEWPORT HEIGHTS BLK 13 LOT 15
Type of Construction:
V -B -SPR
Occupancy Group:
R31U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
0
Flood Zone:
Building Overtime PC Fee:
Bldg Sprinklers:
Y
Description: SFR FIRE SPRINKLERS
Legal Description:
FIRST ADD TO NEWPORT HEIGHTS BLK 13 LOT 15
Contractor:
FIREGUARD SPRINKLER SYS INC
Address:
9543 VICTORIA AVE
FALLS LAKE FIRE & CASUALTY
SOUTH GATE CA 90280
Phone:
714-310.0194
Con State Lie: 992002
Lie Expire: 04130/2020
Bus Lie:
BT30046886
Lie Exp Date:
0 413 012 01 9
Worker's Compensation Insurance
Carrier:
FALLS LAKE FIRE & CASUALTY
Policy No:
FLA0080008.00
Expire:
1212912018
Issued Date: 05/2112018
Setback- Front:
Rear:
Left:
Right:
FIRE Permit: F2018-0299
Project No: 1202-2018
Inspection Requests Phone (949)644-3255
54
try/ d
Architect:-TORSiv
Address: f9 E
Phone: State Lie:
Engineer:
Address:
Phone: State Lie:
Designer: VO JOHN
Address: 526 W SHADYDALE AVE
WEST COVINA CA 91790
Phone: 714-310-0194
Special Conditions:
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL: 56 1
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$7,000.00
Building PC Fee:
$190.00
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
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 :
$225.00
TOTAL FEE :
$419.00
Plan Check Fee :
$419.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL: 56 1
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
IWNER-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 checkmerAs) I h`eavapl11ct drnext to the applicable item(
lection 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, rtior to,its,Issuamce,, arsoreguires the applicant for
is 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-01th•9dbtiorT70001 of Ditisioli Yof 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).
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 structureals mot intended orofferee� %r s V-(S&ctjpn 7044,
Iusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effpR„buil4s or Improves the prope,wa
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 Ni! Aav@tre buopq of pr6ving 4wait s not built or
nproved for the purpose of sale).
I, as,owner of the property, anexclusively 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 nmproves 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 legally
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 perjury that I am licensed under provisions of Chapter 9 (commencing with Secti4�--
icense
) of Division 3 of the Business and Profs sio s Code aqd my license is in full force
nd effect.
Class License No Date Contractor Signature
YORKERS' COMPENSATION DECLARATION
FANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYITORIMINAL PENALTIES AND CIVIL FINES UP TO ON HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY
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 thl
eLformance of the work 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:
Policy Number Expiration Date
is of Agent
certify that, in the pi
if I should become
Iature of Applicant C
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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / . f
hereby affirm under penalty oftpefjury that 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:
I am the property owner or authorized to act on the pr p rty owner's behalf.
I have read this application and the information I havl pr vided is correct.
I agree to comply with all applicable city and county qrdininces and state laws relating to building construction.
I authorize representatives of this city or county/t, e er aboy{e�-identified property for inspection purposes.
:innnhlre of Prnnwrty Owner or Authorized ADentIr Print Property Owner's or Authorized Agent's Name
AC77ON DATE BY IJELLs FIVIV air a V'WrUAIVac rnrn a, UV ..n we v1.11
FEDERAL REGULATIONS PART fit OFTIILE40AND
PERMITEXPIRED AQMD RULE 1403.
I SUBMITTED ASBESTOS N077FICATIOPI TO:
PERMITCANCELLED ❑ EPA
PERMIT EXTENDED ❑ AQMD
❑ ASBESTOS M017HCA710NIS NOT APPLICABLE TO
PERMIT FINAL 1 PROPOSED DEMOLITION.
CERTIFICATEOF
OCCIPANCYISSOED SIGNATURE:
W