HomeMy WebLinkAboutF2017-0492 - Permits1Vr, City of Newport Beach - Building Division IIIIIII�IIIIIII�IIIIIIIIIIIIIIII�IIIIIII FIRE Permit: F2017-0492
'* ' 100 Civic Center Drive, Newport Beach, CA 92660 II� F 2 0 1 7 0 4 9 2 Project No : 2061-2017
E Permit Counter Phone (949)644-3288
-
? ?r'ayv,? Inspection Requests Phone (949)644-3255
Job Address: 1712 GALAXY DR NB Description: SFR FIRE SPRINKLERS (31) HEADS (X2017-0993)
Inspector Area: 3 Legal Description: N TR 4224 LOT 40
Owner: MATTHEWS JOHNIKRISTEN ENGRID Contractor: FIREGUARD SPRINKLER SYS INC
Address: 1718 GALAXY DR Address: 9643 VICTORIA AVE
NEWPORT BEACH, CA 92660 SOUTH GATE CA 90280
Phone: Phone: 714-310.0194
Applicant: VO JOHN
Address: 9543 VICTORIA AVE
SOUTH GATE CA 90280
Phone: 714-310-0194
Code Edit: 2016
Type of Construction:
V-B-SPR
Occupancy Group:
R31U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
1
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
Construction Valuation
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:
FIRE APPROVAL:
$4,600.00
Con State Lie: 992002
Lie Expire: 0413012018
Bus Lie:
BT30046886
Lie Exp Date:
04/30/2018
Worker's Compensation Insurance
Carrier:
SECURITY NATL
Policy No:
SWC1091874
Expire:
12/20/2017
Issued Date:
09/1412017
Setback- Front:
Rear:
Left:
Right:
FEES
Architect:
Address:
Phone: State Lie:
Engineer:
Address:
Phone: State Lie
Designer: VO JOHN
Address: 9543 VICTORIA AVE
SOUTH GATE CA 90280
Phone: 714-310-0194
Special Conditions:
$190.00
Fire Residential Alarm PC Fee :
$0.00 Records Management
$0.00
Planning Counter Review:
$0.00
$0.00
Planning Zoning PC Fee:
$0.00
$0.00
$0.00
Public Works PC Fee :
$0.00
$0.00
Public Works Traffic Plan Check Fee;
$0.00
$225.00
$419.00
Plan Check Fee:
$0.00 Fee Due at. Permit Issuance
Vra • NAER dEPAR IM'Ek'T:
ao c
PP,AN; HECKE[;, BY;,:,;
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUA1NCE OR LAST VRLID INSPECTIOA
•sue •• as • • ••• .a
$4.00
$0.00
$0.00
$419.00
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).
1, 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,
iness 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).
J I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70,
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrac
I am exempt from licensure under the Contractors' State License Law for the following reason:
y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least on
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.le.
signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti°,n 100
nd effect. q /q
icense Class License No Date _I
COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
have and(rwill maintain a certificate of consent to self -insure for workers' compensation, issued by the
rmance of`(he, work for which this permit is issued. PoliGy No.
have and
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
year prior to completion of the improvements covered by this permit, I cannot
nderstand that a copy of the applicable law, Section 7044 of the Business and
of Division 3 of the Business and
Contractor
'Iyd my license is in full force
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
Industrial Relations as provided for by Section 3700 of the Labor Code, for
I mtain worker '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'
crip ^oI numbe re:
17 Y 1 '`' o I fvmber Expiration Date
is of Age '4Q4—� V 1
certify that, in the performan e o the work for which this permit is issued, I shall not employ any person in any
if I should become subject the orker gompensation provisions of Section 3700 of the Labor Code, I shall
iature of Applicant I . ,
so as to become subject to the workers' compensation laws of California, and
r comply with those gwvision;. t
iECLARATION REG4RDING C RUCTION LENDING AGENCY
hereby affirm under penalty of p rj that there is a construction lending agency for the performance of the work for which this permit
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 property owner's behalf.
I have read this application and the information I have pro tl d is correct.
I agree to comply with all applicable city and county ordin nc�, ands ate laws relating to building construction.
I authorize representatives of this city or county'kgMer tnr property for inspection purposes.
signature of Property Owner or Authorized Agent Print Property Owner's or Authorized AgI
(Section 3097, Civil Code).
�!J
ACTION
DATE
DECLARATION OF COMPLIANCE MTN CODEOF
FOR OFRCE USE ONLY
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