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Home My WebLink AboutF2022-0209 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIII�I�IIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 2 0 2 0 9 Permit Counter Phone (949)644-3288 r� Job Address: 20401 BIRCH ST NB Inspector Area: FIRE Owner: FERRADO BAYVIEW LLC Address: 20411 SW BIRCH ST #360 NEWPORT BEACH, CA 92660 Phone: Applicant: WILLIAMS DOMINIQUE Address: 1354 S PARKSIDE PL ONTARIO CA 91761 Phone Code Edit : 2019 Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: No of Units Flood Zone: Bldg Sprinklers: j Construction Valuation V-B-SPR B 0 0 FIRE Permit: F2022-0209 Project No : 1048-2022 Inspection Requests Phone (949)644-3255 Description: COMM -SPRINKLER MONITORING SYSTEM. NEW ALARM COMMUNICATOR, Legal Description: TR 706 FOR OF LOTS 64 65 66 97 98 & 99 Contractor: H C I SYSTEMS INC Address: 1354 S PARKSIDE PL ONTARIO CA 91761 - Phone: 909-628-7773 Con State Lic: 906493 Lie Expire: 02/29/2024 Bus Lie: BT30042287 Lie Exp Date: 02128/2023 Worker's Compensation Insurance Carrier: FEDERAL INSURANCE CO Policy No: 64309498 Expire: 03/0212023 3 Issued Date: 0412012022 0 Setback- Front: X Rear: Y Left: n� �y Building PC Fee : Building Overtime PC Fee: Building Extention Fee : Building Investigation Fee Fire Plan Check Fee: Fire Permit Fee : Building Permit Fee TOTALFEE PROCESSED BY: ZONING APPROVAL: $1$09.00 FIRE APPROVAL: FEES Architect: Address: Phone: State Lie Engineer: Address: Phone: State Lie: Designer: VALENZUELA CAEZAR Address: 1354 S PARKSIDE PL ONTARIO CA 91761 Phone: Special Conditions: $0.00 Fire Residential Alann PC Fee : $0.00 Records Management: $14.00 $0.00 Planning Counter Review : $0.00 $0.00 Planning Zoning PC Fee : $0.00 $0.00 $0.00 $145.00 Public Works PC Fee : $0.00 $0.00 $283.00 Public Works Traffic Plan Check Fee; $0.00 $0.00 $442.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $442.00 OTHER DEPARTMENT: PLAN CHECKED BY.:�° ° ° % o - ° ° APPROVAL TO ISSUE: �., PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID IISPE(TIOY °O •° o o�° o o ° 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) i(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 U 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). ❑ 1 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 legall) 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) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No D gltX L'0 200 Z? Contractor Signatu WORKERS' COMPENSATION DECLARATION WARNING: FAILURE 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37DG OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 hereby affirm under penalty of perjury one of the following declarations: 111 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 the p rmance of the work for which this permit is issued. Policy No. I ave 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' compensatior �insur nce car ier and policy number are: , / 2 / ' /t C` _ 2 ler Fec�cx�1 �51A`FOiAAC.�— W. Policy Number 5`Y 2,)oq �I'7 b Expiration Date �" ,� 2. � 3 (Name 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 subject to the workers' compensation laws of California, and , if I should become subject to �the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. rature of Applicant Date -z Lk ftom1, CLARATION REGARDING SONSTRUCTION LENDING AGENCY " V �reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work far which this permit is issued (Section 3097, Civil Code). tder's Name Lender's Address 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 enstte�the above-identifed property for inspection purposes. r,/) (nature of Property Owner or Authorized Agent r� /JL.�1` ' Print Property Owner's or Authorized Agent's Name //\ I YV6 tn.G Lli ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF T1TLE40 AND AQMD RULE 1403. PERMIT EXPIRED • • • • • ' ❑ I SUBMITTED ASBESTOS N071FICATIONTO:. ❑ EPA ❑ AQMD PERMIT CANCELLED • • • • • : • PERMITEXTEP70E➢ . �� . • . • • • •• ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. , PERMIT FINAL .• CERT7FICATEOF • • • ° • . e SIGNATURE: . OCCUPANCYISSUED •• o e• e e e "eo ego ee