The URL can be used to link to this page

Home My WebLink AboutF2018-0628 - Permits1Y1r�$ City of Newport Beach - Building Division - a ). 100 Civic Center Drive, Newport Beach, CA 92660 I@ h x� Permit Counter Phone (949)644-3288 c'"�MrnY�xa Job Address: 504 HAZEL DR NIB Inspector Area: 5 Owner: .504 HAZEL DRIVE LLC Address: 504 HAZEL DR CORONA DEL MAR, CA 92625 Phone: Applicant: VO JOHN Address: 526 N SHADYDALE AV WEST COVINA CA 91790 Phone: 714.310-0194 Code Edit : 2016 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: Y Construction Valuation Building PC Fee : Building Overtime PC Fee Building Extention Fee : Building Investigation Fee Fire Plan Check Fee: Fire Permit Fee : Building Permit Fee TOTAL FEE PROCESSED BY: $4,000.00 FIRE Permit F2018-0628 Project No: 2786-2018 Inspection Requests Phone (949)644-3255 State Lie: State Lie: moms 0 0 moms 0 0 cm00000 Issued Date: Special Conditions ,PERMITREVISED 01-10-19-,� ° Setback- Front: Rear: ommoom Left: o Right: .... I $202.00 $0.00 $0.00 $0.00 $0.00 $0.00 $240.00 $446.00 ZONING APPROVAL: FIRE APPROVAL: FEES Description: SFR FIRE SPRINKLERS (X2017-3225) 35 HEADS Legal Description: N TR 673 BILK B LOT 36 Contractor: FIREGUARD SPRINKLER SYS INC Architect: Address: 9543 VICTORIA AVE Address: o 0 o m SOUTH GATE CA 90280. $0.00 Phone: 714-310-0194 Phone: Con State Lie: 992002 - Engineer: Lie Expire: 04/30/2020 Address: Bus Lic: BT30046886 Lie Exp Date: 0413012019 Phone: Worker's Compensation Insurance Designer: Carrier: FALLS LAKE FIRE & CASUALTY Address: Policy No: FLA0080008 Expire: 12/29/2019 Phone: State Lie: State Lie: moms 0 0 moms 0 0 cm00000 Issued Date: Special Conditions ,PERMITREVISED 01-10-19-,� ° Setback- Front: Rear: ommoom Left: o Right: .... I $202.00 $0.00 $0.00 $0.00 $0.00 $0.00 $240.00 $446.00 ZONING APPROVAL: FIRE APPROVAL: FEES m m m mmmmmm 0 Fire Residential Alarm PC Fee : $0.00 Records Management: o o 4$0600 Planning Counter Review: $0.00 o 0 o m Planning Zoning PC Fee : $0.00 $0.00 Public Works PC Fee : $0.00 $0.00 Public Works Traffic Plan Check Fee; $0.00 Plan Check Fee : $446.00 Fee Due at Permit Issuance : $0.00 OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: X4✓`� PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION m o mmm000 0 0 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 checkmark(s) I have placed next to the applicable iterr(s) lection 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 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 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). 7 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, Iusiness 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). 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: Iy 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.htmi. ignature 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 5 tion 000) of D' Ion the Business and Prfess ns Code, and my license is in full force nd effect. 11C icense Class License No Date 6 Contr for Signature YORKERS' COMPENSATION DECLARATION ARNING: FAILURE Ta 21 RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO ER TO CRIMINAL PENALTIES AN IL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPEN----1 AMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. here4affirm under penalty of perjury one of the following declarations: ... m. I Flave and .will a(.ntain 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 p ftrlyfance of thB work for which this permit is issued. Policy No. and Will"%idtain 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 a carrier and policy number are: .. • . Policy Number Expiration Date Agent . • Phone # y 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 sub'ect to the workers' compensation laws of California, and agre Ihould4acecle subct the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply wit a prov si s. s of Appllpan • — - DateT i C� 'Se ON,5C. ARD NG CO STRUCTI NDI AGENCY affir under peon pea at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). JUa Lender's Address _. my signature below, I cddito each of the following: I am the property owner or uthorized to act on the pn I have read this application and the information I have I agree to comply with all applicable city and county oI I authorize representatives of this city or county to ant of Property Owner or Auth 'zed,4gent- ACTION I IDA TE BY FINAL ner's behalf. is correct. and state laws relating to building construction. uraidentified property for inspection purposes. \�\ Print Prooertv Owner's or FEDERAL REGULATIONS PART 61 OFTI`EE411MD AQMD RULE 1603. ❑ I SUBMITTEDASBESTOS NOTLFICATION TO:- ❑ EPA ❑ AQMD ❑ ASBESTOS NOITHCARONIS NOF APPLICABLE TO PROPOSED DEMOLITION. OCCUPANCYTSSDED IV m I' SIGNATURE. G