HomeMy WebLinkAboutF2020-0216 - PermitsCity of Newport Beach - Building Division FIRE Permit: F2020-0216
100 Civic Center Drive, Newport Beach, CA 92660 III F 2 0 2 0 0 2 1 6 II Project No: 0851-2020
Permit Counter Phone (949)644-3288
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r`ayc�,ro'? Inspection Requests Phone (949)644-3255
Job Address: 1224 HIGHLAND DR NB Description: SFR FIRE SPRINKLERS (26 HEADS) X2019-3351
Inspector Area: 3 Legal Description: N TR 3031 LOT 74
Owner: F CAMPBELL Contractor: (FIRE PROTECTION Architect:
Address: 1227 SOMERSETLN Address: 9559 NIGHTINGALE AVE Address:
NEWPORT BEACH, CA 92660 FOUNTAIN VALLEY CA 92708
Phone: Phone: 714-234-9633 Phone: State Lie:
Applicant: VU ANTHONY Con State Lie: 1038755 Engineer:
Address: 9559 NIGHTINGALE AVE Lie Expire: 04/30/2022 Address:
FOUNTAIN VALLEY CA 92806 Bus Lie: BT30067240
Phone: 714-231-5108 Lie Exp Date: 05/3112021 Phone: State Lie:
Code Edit: 2019 Worker's Compensation Insurance Designer: VU ANTHONY
Type of Construction: VB Carrier: EXEMPT Address: 9559 NIGHTINGALE AVE
Occupancy Group: R3/U Policy No: no employees FOUNTAIN VALLEY CA 92806
Added /New sq.ft. Bldg: 0 Expire: Phone:
Added /New sq. ft. Garage: 0 -
No of Stories: 1 Issued Date: 06/0212020 Special Conditions:
No of Units : 0 Setback- Front:
Flood Zone: Rear: .gam
Bldg Sprinklers: Y Lett:
Right: \i
FEES
Construction Valuation: $4,200.00 -
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 as: $0.00 Public Works Traffic Plan Check Fee; $0.00
Building Permit Fee: $240.00
TOTAL FEE : $446.00 Plan Check Fee : $202.00 Fee Due at Permit Issuance : $244.00
PROCESSED BY: _ MIR OTHER DEPARTME!MT
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ZONING APPROVAL: PLAN CHECKED BW-.
FIRE APPROVAL: 1i(/f APPROVAL TO ISSUE:
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PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID �NSPEr) ION'
IWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for thereason(s) indicated below by the checkmark(s) I have placed next to the applicable item(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).
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,
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).
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:
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. 1 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:hftp://www.leginfo.ca.gov/calaw.html.
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 Section 7000) of Division 3 of the Busi an JPras Code and-lieense is in full force
nd effect.
icense Class License No D ontractor Signature
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15700,0001, IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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
erformance of the work for which this permit is issued. Policy No.
'have 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'
irance carrier and policy number are:
per Policy Number Expiration Date
Of
in the performs c hN •mrk 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
become subje o t e workel'V' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I j
mature of Applicant uaw,)Ie�•
CLARATION REGAR NG STRUCTION LEN G GENCY
Sreby affirm under penalty of perjury that there is a constr ction lending agency for the performance of the work for which this permit is issued (Section
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 oAhae
owner's behalf.
I have read this application and the informatioded is correct.
I agree to comply with all applicable city and cces and state law1� relating to building construction.
I authorize representatives of this city or coun'dentifie r3roperty for inspection purposes.I,-- II,1mature of Prooertv Owner or Authorized Aoent_ Print Property Owner's or Authorized Agent's Name4A
ACTION
PERMITEXPIRED
PERMIT CANCELLED
PERMIT FINAL 4. I 1
CERTIFICATE OF
OCCUPANCYISSUED
.-DATE. • up •r1 aBYi••
n e w• •m +o .
FEDERAL REGULATIONS PART 61 OF TITLE40AND
AQMD RULE 1403.
❑ ) SUBMITTEDASB€STOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS N01IFICA170MIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
Civil
FDR