HomeMy WebLinkAboutf2022-0058 - Permitshaw, City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 1 SEYNE NB
Inspector Area: 6
Owner: YU BING & QIN WANG
Address: 1 SEYNE
NEWPORT BEACH, CA 92657
Phone:
Applicant: STEPHEN CUCULIC FIRE PROT
Address: 33041 CALLE PERFECTO
SAN JUAN CAPISTRANO, CA 92675
Phone: 714-608-1175
Code Edit: 2019
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:
Bldg Sprinklers:
N
*F2022-0058* FIRE Permit: F2022-0058
Project No : 0281-2022
Inspection Requests Phone (949)644-3255
Description: SFR FIRE APRINKLER SYSTEM 6 HEADS (X2021-2142)
Legal Description:
Contractor:-
STEPHEN CUCULIC FIRE PROT
Architect:
Address:
33041 CALLE PERFECTO
Address:
SAN JUAN CAPISTRANO, CA 92675
Phone:
714-608-1175
Phone:
State Lic:
•...
Con State Lic:
964483
Engineer:
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Lic Expire:
11/30/2022
Address:
° • •
° ° ° ° • °
Bus Lic:
BT30072160
: °.•'
• °
Lic Exp Date:
06130/2022
Phone:
State Lic:
°
•.•
.
Worker's Compensation Insurance
Designer:
CUCULIC STEPHEN
° • °
Carrier:
NO EMPLOYEES
Address:
33041 CALLE PERFECTO
•°'°°,°•:
Policy No:
SAN JUAN CAPISTRANO, CA
92675. :
°. ° °•
Expire:
Phone:
° • ° •
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Issued Date: 02103/2022
Special Conditions:
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Setback- Front:
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Rear:
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Left:
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Right:
FEES
Construction Valuation:
$3,000.00
Building PC Fee :
$222.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
$2.00
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:
$269.00
TOTAL FEE :
$493.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$493.00
PROCESSED BY:--.. OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
DWNER-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 U 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
improved 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
apply 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 legally
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 Coo* WhVijilable upon request when this application is submitted or at the following Web site:http:/Avww.leginfo.ca.gov/calaw.htmi.
Signature of Propertp@wner or Authorized Agent Date
L46ENOED CONTRACTOR'S DECLARATION
I hereby affirm und®r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business anndd Professions Code,, and my license is in full force
ar8effAr. A ,_ /
OcenSE Class License No Date 2 22 Contractor Signature
VV6RK%RS' C6AjjIVSATION DECLARATION
NAIRNIA& FAILUR%TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
CdD"6RCOMPENSAT16N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I .h6rP.b1} affirm under penalty of perjury one of the following declarations:
:6CA=0 and wiil6m1i9tain 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,
rfowo rmance of We rlafor which this permit is issued. Policy No.
66
LUZand will6mall;;ln 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' compensatior
i sL a'tlCe carrieNvPp licy number are:
Policy Number
F Agent rnor
ify 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
should become supject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with the
of Applicant
Date
to the workers' compensation laws of California, and
2
IECLARATION REGAIJDIN—G ebigMUCTION LENDING AGENCY \ t
hereby affirm 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).
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 property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction. /
I authorize representatives of this city or county to enf€r the above -identified property for inspection purposes. N n
of
AC77ON I DATE
PERMIT CANCELLEL
PERMIT EkTENDEO
or Authorized
FEDERAL REGULATIONSPART 61 OF TITLE40AND
AQMD RULE 1403.
❑ / SUBMITTEBASBESTOS NOAFICATIOM TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOIIFICA77ON IS NOT APPLICABLE TO
PROPOSED BEMOLITIOIV.
OCCUPANCYISSUED I I I SIGNATURE: