HomeMy WebLinkAboutF2022-0171 - Permits6"'& City of Newport Beach - Building Division IIIIIIIII��IIIIIIIIIIIIIIIIIIIIII II FIRE Permit: F2022-0171
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100 Civic Center Drive, Newport Beach, CA 92660 I F 2 0 2 2 0 1 7 1 Project No: 0850-2022
Permit Counter Phone (949)644-3288
r'�isaaA"Ra Inspection Requests Phone (949)644-3255
Job Address: 514 36TH ST NB
Description: MFR FIRE SPRINKLERS (X2021-2260) MOVE 2 HEADS
Inspector Area: 1
Legal Description: CANAL SECTION BLK 535 LOT 8
Owner: GLASS CORY
Contractor:
FIREGUARD SPRINKLER SYS INC
Architect:
Address: 514 36TH ST
Address:
7907 LEEDS ST
Address:
NEWPORT BEACH CA 92663
DOWNEY CA 90242
Phone:
Phone:
714.310-0194
Phone:
State Lic:
Applicant: VO JOHN
Con State Lic:
992002
Engineer:
Address: 526 N SHADYDALE AV
Lic Expire:
0413012022
Address:
WEST COVINA CA 91790
Bus Lic:
BT30046886
Phone: 714-310-0194
Lic Exp Date:
0413012022
Phone:
State Lic:
Code Edit : 2019 -
Worker's Compensation Insurance
Designer:
VO JOHN
Type of Construction: V-B-SPR
Carrier:
FALLS LAKE FIRE 8. CASUALTY
Address:
526 N SHADYDALE AV
Occupancy Group: R3/U
Policy No:
FLA0080008
WEST COVINA CA 91790
Added /New sq.ft. Bldg: 0
Expire:
12/2912022
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 3
Issued
Date: 03/30/2022
Special Conditions:
-
No of Units : 0
Setback- Front:
Flood Zone: X
Bldg Sprinklers: Y
Rear:
Left:
Right:
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FEES
Construction Valuation:
$400.00
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee :
$0.00
Records Management : $0.00
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:
$166.76
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$239.50
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$406.25
Plan Check Fee :
$0.00
Fee Due at Permit Issuance: $406.25
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
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APPROVAL TO ISSUE:
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PERMIT EXPIRES 180 DAYS AFTER ISSU9A19�E GR Ls1ST VALID INSPECTION
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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
lot 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 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
mproved for the purpose of sale).
L.I 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, 1 cannot legal
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.htmi.
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 700) of Division 3 of the Business and Prof ssions ode, and my license is in full force
and effect. 2
License Class License No Date ✓ /3Contractor Signature
NORKERS' COMPENSATION DECLARATION
IARNING: 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
�OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0106 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
`ormance 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:
ie of Agent
certify that, in the p
, if I should become
Policy Number
Date
of t 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
the w rkeftorppensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I _ ,
ignature of Applicant - Date: 7V
DECLARATION REGARD' G ON T UCTION LENDING AGENCY
hereby affirm under penalty of perj rhat 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
y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the propert er's behalf.
I have read this application and the information I have pro ided correct.
I agree to comply with all applicable city and county ordin nces a state laws relating to building construction.
I authorize representatives of this city or county to enter t e abovedentifed property for inspection purposes.
rty Owner or ignature of PropeAuthorized Age Print Property Owner's or Authorized Agent's Name
ACTION
DATE
DECLARATION OF COMPLIANCE tMTH CODE OF
. FOR OFFICE USE ONLY
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