HomeMy WebLinkAboutF2022-0075 - PermitsCity of Newport Beach - Building Division 11Ip III1II1II11II1II111II1111111IIIp11I1p1111111
Orm Civic C unterr Phone (949)644-3288 Beach, CA 92660 F z 0 z z 0 0 7 5
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Job Address: 434 FERNLEAF AVE NB
Inspector Area: 5
Owner: MARTIN KAREN & JOHN
Address: 1724 PORT MARGATE PL
INS CA 92660
Phone: 949.278-0541
Applicant: NGUYEN VINCENT
Address: 9182 ALWICK CIR
GARDEN GROVE CA 92841
Phone: 714-231-5108
Code Edit: 2019
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
3
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
$6,600.00
FIRE Permit: F2022-0075
Project No : 0376-2022
Inspection Requests Phone (949)644-3255
Description: MFR FIRE SPRINKLERS (X2020-3012) 42 HEADS
Legal Description: CORONA DEL MAR BILK 433 LOT 16
Contractor:
XFIRE PROTECTION
Architect:
Address:
9182 ALWICK CIR
Address:
GARDEN GROVE CA 92841
Phone:
714-231-5100
Phone:
State Lic:
Con State Lic:
1084661
Engineer:
Lic Expire:
12/31/2023
Address:
Bus Lic:
BT30077912
Lic Exp Date:
02/28/2023
Phone:
State Lic:
Worker's Compensation
Insurance
Designer:
VU ANTHONY
Carrier.
NO EMPLOYEES
Address:
9559 NIGHTINGALE AV
Policy No:
FOUNTAIN VALLEY CA 92708
Expire:
Phone:
Issued Date: 02/14/2022 Special Conditions:
Setback- Front:
Rear: �^'
Left: �, J r% O C 1 OR
Right: I g ^ 6.d 1
FEES
$222.00
Fire Residential Alarm PC Fee:
$0.00 Records Management: $6.00
$0.00
Planning Counter Review:
$0.00
$0.00
Planning Zoning PC Fee :
$0.00
$0.00
$0.00
$0.00
Public Works PC Fee:
$0.00 $0.00
$0.00
Public Works Traffic Plan Check Fee;
$0.00
$269.00
TOTAL FEE : \x' $497.00 Plan Check Fee
PROCESSED BY: ''Y
ZONING APPROVAL:
FIRE APPROVAL:
$0.00 Fee Due at Permit Issuance : $497.00
, g7H n%DEP6.RTMEA i :
=PLAN CHECME BY,:
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST ✓A1-16 INSPECTIO(I
R 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 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).
❑ 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 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 Pr f ssions Code, and my license is in full force
and effect. License Class License No Date &ontractor 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 ($100,000), 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:
❑ 1 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 th,
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 and policy number are:
f Agent _
ify that, in the
should bec9D
re of Applican
Policy Number
Date
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
he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r I
I hereby affirm under penalty of perjury that there iA a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By 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 he provided is correct.
I agree to comply with all applicable city and county or finances and state laws relating to building construction.
I authorize representatives of this city or county to t have-identi'ad property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name --L��i-JA* Date � .
ACTION
DATE
BY I
DECLARATION OFCOMPLIANCE KITH CODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQA) RI:'LE 1403.
PERMIT EXPIRED
_[] SUBUITTED ASBESTOS NOTIFICATION' TO:
�] E"A
❑ AQMD
PERMfTCANCELLED
_
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CER7lA'CATE O€
S1,3NATURE:.
OCCUPANCYISSUED