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Home My WebLink AboutF2019-0312 - PermitsI' City of Newport Beach - Building Division IIIIIIIIIIIIIII IIIIIIIIII�IIIIII IIIIIIIII FIRE Permit: F2019-0312 100 Civic Center Drive, Newport Beach, CA 92660 II� F 2 0 1 9 0 3 1 2 Project No: 1177-2019 [. °} Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 2121 SEVILLE AVE NIB -. Description: SFR FIRE SPRINKLERS (X2018318) 43 HEAD Inspector Area: 1 Legal Description: N TR 948 LOT 101 Owner: SEDONA HOMES INC Contractor: FIREGUARD SPRINKLER SYS INC Archit Address: 40101 MONTEREY AV UNIT BI -214 Address: 9543 VICTORIA AVE Address: RANCHO MIRAGE CA 92270 SOUTH GATE CA 90280 Phone: Phone: 714-310-0194 Phone: State Lic: Applicant: VO JOHN Con State Lic: 992002 Engineer: Address: 526 N SHADYDALE AV Lic Expire: 0413012020. Address: WEST COVINA CA 91790 Bus Lic: BT30046886 Phone: Lic Exp Date: 05131/2020 Phone: State Lic: Code Edit :2016 Worker's Compensation Insurance Designer. JOHN Type of Construction:. V -B -SPR Carrier: FALLS LAKE FIRE .& CASUALTY - 526 N SHADYDALE AV Occupancy Group: R3/U Policy No: FLA0080008 ES OVINA CA 91790 Added /New sq.ft. Bldg: 0 Expire: 12129/2019:Added /New sq. ft. Garage: 0 No of Stories: 3 Issued Date: 0512312019 (Addr Special Con Revised # of hes s No of Units : 0 Setback- Front: 8/15119 Flood Zone: Rear: Bldg Sprinklers: Y Left: Right: FEES Construction Valuation: ..$6,000.00 Building PC Fee : $202.00 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 : $240.00 TOTAL FEE : $446.00 Plan Check Fee : $446.00 Fee Due at Permit Issuance : $0.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: o ° c PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION ° ° •> ° ° o ° ° °° ®° ° o 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 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 (_) all of or (_) 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 im roved 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 ap ly 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: 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 legalh 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 Section/7000) f Division 3 of the Business and Prof sio ,gde, and my license is in full force and effect. �i�% V License Class License No Date r t Contractor Signatur NORKERS' COMPENSATION DECLARATION 1 NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 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: ;111 Eve 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 th 3e ance 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: is of Agent certify that, in the p1 if I should become Policy Number Date ofa work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the the orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions7. nature of Applicant ✓ I uare� CLARATION REGARDING C - ST UCTION LENDING AGENCY Ireby affirm under penalty of per 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 ojthe ope y owners behalf. I have read this application and the informatiopro 'ded is correct. I agree to comply with all applicable city and rdina es and state laws relating to building construction.I authorize representatives of this city or couner t e above -identified property for inspection purposes. J nature of Property Owner or Authorized Agent Print Property Owner's or Authorized A ant's Name S 0 Civil Code). 0kr, G laws of California, and ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART til OFTITLE40AND AQMO RULE 1403. PERMfTEXPIRED • • ❑ 1 SUBMITTED ASBESTOS N071FICATION TO: D EPA • PERA41TCANC€LLED • • D AQMD P£RMIT€XTENDED ° • • • • . ❑ ASBESTOS NOTIRCAITONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINA! • • ; • • 2Y• . Zo C€RTIFICAT€OF OCCUPANCYISSd1E9 ••• �•• SIGNATURE: