HomeMy WebLinkAboutF2019-0095 - Permits (2)28
'!e City of Newport Beach - Building Division 1111 II
" 100rm Civic Center Dri one (Newport Beach CA 92660 F 2 0 1 9 0..0 9 5
FIRE Permit: F2019-0095
Project No : 0420-2019
Inspection Requests Phone (949)644-3255
Job Address: 420 HELIOTROPE AVE NB
Description: MFR FIRE SPRINKLERS (X2018-1356) 46 HEADS
FEES
Inspector Area: 5
Legal Description: CORONA DEL MAR BLK 435 LOT 6 '
$7,000.00
Building PC Fee:
$202.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
e0ea
Building Overtime PC. Fee:.
Owner: LEE
Contractor: FIREGUARD SPRINKLER SYS INC
Architect:
Building Extention Fee :
$0.00
Planning Zoning PC Fee`.
Address: 819 N RICHMAN AV
Address: 9543 VICTORIA AVE
Address:
$0.00
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$0.00
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FULLERTON CA 92832
SOUTH GATE CA 90280
$0.00
$0.00
Fire Permit Fee :
V!
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Phone:
Phone: 714-310-0194
Phone:
State Lic:
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Applicant: VO JOHN
Con State Lic: 992002
Engineer.
$446.00 Fee Due at Permit Issuance :
$0.00
Address:. 526 N SHADYDALE AV
Lic Expire: 04130/2020
Address:.
' W COVINA CA 91790
Bus Lic: BT30046886
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Phone: 714.310-0194
Lic Exp Date:. 0513112020
Phone:
State Lic:
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Code Edit: 2016
Worker's Compensation Insurance
Designer:
VO JOHN
•
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Type of Construction V -B -SPR
` Carrier: FALLS LAKE FIRE & CASUALTY
Address:.
526 N SHADYDALE AV
Occupancy Group: R31U
Policy No: FLA0080008W
COVINA CA 91790
:o e e e o
Added /New sq.ft. Bldg: 0
Expire: 12/29/2019 -
Phone:
714.310-0194
Added /New sq. ft. Garage: 0 .
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No of Stories: 2
Issued Date: 02125/2019
Special Conditions:
PERMIT REVISED 08-27-19
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No of Units : 0 Setback- Front:
Flood Zone: Rear:
Bldg Sprinklers: Y Left:
Right
PROCESSED BY:OTHER DEPARTMENT:
ZONING APPROVAL: - PLAN. CHECKED BY::
FIRE APP ROVAL: - APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
Construction Valuation:
$7,000.00
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 APP ROVAL: - APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
INER-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)
ction 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
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
fessions 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
roved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
,ly to an owngj pfproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt trcm licensure under the Contractors' State License Law for the following reason:
T13rgnaturELbPJQw I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion Of the improvements covered by this permit, I cannot legally
a uctureothat �trave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
fegsions Cor%, Is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nafiare of Property Owner or Authorized Agent Date
TENSED g0NJF4%CTOR'S DECLARATION
:reby affirm utieler penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect' n 70 ) of ivision 3 of the Business and Pr essl ns Code, and my license is in full force
le$ect. ... X
Mga,Class :. License No le tJ Contr ctor Signature
)hR�KERS' COMPENSATION DECLARATION
Y"9- FAILURE i0 SEW RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIV FI S UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
T OFCOMPENB"W,, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
iWW affirm under penalty of perjury one of the following declarations:
T fiSve and 414ma stain 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 IN
53PWnce of the work for which this permit is issued. Policy No.
Ylfava 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' compen
u nce carrier and policy number are:
Tier Policy Number Expiration Date
Tie of Agent Phone #
certify 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 s ject to the workers' compensation laws of California, and
I, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos p ' 'ons.
nature of Applicar-'/'' a 507/ j
TIO GAE RDING CONSTRUCTION LENDING AGENCY
�SelDya m under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider's N e Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on t roperty owner's behalf.
I have read this application and the information ha provided is correct.
I agree to comply with all applicable city and co my r r the b and state laws relating to building construction. V 'i
I authorize representatives of ty or count to an r the above -identified property for inspection purposes. ,J
nature of Prooertv Owner or zed Aaent _ Print Property Owner's or Authorizent's Name U 1 D e
ACTION DATE. By
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FEDERAL REGULATIONS PART 61 OFTITLE40AND
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PERMITEXPIRED
I SUBMITTEDASBESTOS NOTfFICATION TO:
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P€RMITCANCELLED
PERMITEXTENDED
ASBESTOS NO17RCATIONIS NOT APPLICABLE TO
PERMfTFtNAI
A OPOSEDDEMOIITION
CERTIHCATEOF
SIGNATURE:
OCCUPANCYISSUED