HomeMy WebLinkAboutF2020-0307 - Permits (2)xMlllow City of Newport Beach - Building Division II II II IIIIIIIIII IIIIIIIII IIIIIIIIIIIII III II
{- 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 0 0 3 0 7
t; u - Permit Counter Phone (949)644-3288
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Job Address: 12 SURF5PRAY BLUFF NB
Inspector Area: 6
Owner: LAIIZHU
Address: 12 SURFSPRAY BLUFF
NEWPORT COAST CA 92657
Phone:
Applicant: CUCULIC STEVE
Address: 33041 CALL PERFECTO
SAN JUAN CAP CA 92675
Phone: 714-608-1173
Code Edit : 2019
Type of Construction:
V-BSPR
Occupancy Group:
R3/U
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
TOTAL FEE
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
$0.00
FIRE Permit: F2020-0307
Project No: 1284-2020
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS (15) HEADS (X2020-0179)
Legal Description:
Contractor:
STEPHEN CUCULIC FIRE PROT
Address:
33041 CALLE PERFECTO
SAN JUAN CAPISTRANO, CA 92675
Phone:
714-608-1175
Con State Lie: 954483
Lie Expire: 1113012020
Bus Lie: BT30072160
Lie Exp Date: 0613012021
Worker's Compensation Insurance
Carrier: NO EMPLOYEES
Policy No:
Expire:
Issued Date: 07/22/2020
Setback- Front:
Rear:
Left:
Right:
FEES
$202.00
Fire Residential Alarm PC Fee
$0.00
Planning Counter Review:
$0.00
Planning Zoning PC Fee:
$0.00
$0.00
Public Works PC Fee:
$0.00
Public Works Traffic Plan Check Fee;
$240.00
$444.00 Plan Check Fee :
Architect:
cc
Address:
Phone:
State Lie:
Engineer:
Address:
UJ
Phone:
State Lie:
Designer:
CUCULIC STEVE
V
Address:
33041 CALLE PERFECTO
SAN JUAN CAP CA 92675
1
Phone:
714-608-1173
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Special Conditions: LANDSLIDE AREA
$0.00 Records Management: $2.00
$0.00
$0.00
$0.00
$0.00 $0.00
$0.00
$0.00 Fee Due at Permit Issuance : $444.00
OTHER. DEPARTMENT:
P,AN.GHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 18d DAYS AF7 ER ,SSUABCE ORRLAST VALID INSPECTION
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 items)
(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).
❑ 1, 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,
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 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 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 Date 24) Contractor Signature<
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 1$100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I 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 thf
performance of the work for which this permit is issued. Policy No.
have 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'
rance carrier aftfgolicy number are:^ _ n
Date
of Agent
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 su)Ject to the workers,cpmpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Of
CLARATION REGAVtDWG'CONSMCTION LENDING AGENCY -� I I
:reby affirm under p nalty 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 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 griter the above -identified property for inspection purposes.
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULAT OKS FART 61 OF TGTLE40AND
AQ41UF?Ul E 1403.
PERMIT EXPIRED
❑ I UOMITFcD AS13ESTOS 10010CATON TO:
,7 EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
ASBESTOS NOIIFICA17ONIS NOT APPLICABLE TO
PROPJSED'• LEMOLITION.
PERMIT FINAL
CERTIFICATEOF
SIGNATURE:""
OCCUPANCYISSUED