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Home My WebLink AboutF2022-0443 - Permits�EWPORT City of Newport Beach II II I I II I II I II II II IIII II O� a Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 U tea.. S Inspection Requests Phone: (949) 644-3255 C9</F00.��P newportbeachca.gov/inspections Combination Type - Work Class - New COMB Permit: F2U22-0443 Plan Check No : PC2022-2085 Issued Date : 08/24/2022 Inspection Area : 3 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 1500 GALAXY DR Legal Desc : N TR 4224 BLK LOT 67 f ., Description : SFR FIRE SPRNKLER SYSTEM 44 HEADSA (X2022-0578) 5`N Idj 3j, Owner: JOHN GOULD Contractor : STEPHEN CUCULIC FIRE PROT Architect Address : 32 SEWALL ST WEST NEWTON, MA 2465 Address : 33041 CALLE PERFECTO SAN JUAN Address CAPISTRANO, CA 92675 Phone : Phone : (714) 608-1175 Phone Con State Lie : 954483 State Lie Applicant: STEPHEN CUCULIC FIRE PROT Lie Expire : 11/30/2022 Address : 33041 CALLE PERFECTO SAN JUAN Bus Lie : BT30072160 Engineer CAPISTRANO, CA 92675 Phone: (714) 608-1175 Bus Lie Expire : 06/30/2023 Address Workers' Compensation Insurance Phone: Owner/Builder: Carrier: EXEMPT Address : Policy No: NO EMPLOYEES Designer: STEPHEN CUCULIC FIRE PROT Phone : W. C. Expire: Address : 33041 CALLE PERFECTO SAN JUAN CAPISTRANO, CA 92675 Phone: (714) 608-1175 Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : $11,000.00 Type of Construction : V-B Fire Hazard Zone : No Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : R3/U No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 1 Added/New sq. ft. Garage: 0 Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone : X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penally 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 constrict, 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), El I, as owner of the property, or my employees with wages as their sole compensation, will de L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' Slate 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 arenot 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 ra�plply 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). tJ I am exempt from licensors under the Contractors' Slate License Law for the fallowing reason By my signature below I acknowledge that, except for my personal residence in which I must have msided 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 this applicable law, Section 7044 or the Business and Professions Code, is available upon request when this application is submitted or at the following Web site,http:lfwww.leginfo.ca.gov/calaw. html. Signature of Property Owner or Authorized Agent D to LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 0) Qfi n 3 of the Business and P slons C , and my license is in full force and effect. License Class License No Dat Contractor Signet r WORKERS' COMPENSATION DECLARATION NANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 7 OUSAND DOLLARS CEt 00,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury oneof the following declarations: 7 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 th erformance of the work for which this permit is Issued. Policy No. ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code.. for theperformance of the work for which this permit is issued. My workers' compensatiol nsurance carrier and policy number are: lamer policy Number Expiration Date lame of Agent Phone # 71 certify that, in th performance of he work f which ills pe nit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre rat. If I should beco uojecl t orker mpensabon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Ilgnature of Applica t _ Date IECLARATION RE RDIN 0 C ON LENDING AGENCY hereby affirm under penalty of p 'u hat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil enders 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 have provided is correct. I agree to comply with at applicable city and county ordinanc rid s laws relating to building construction. I authorize representatives of this city or county to nt e a e e of property for inspection purposes. Signature of Property Owner or Authorized Agent I Print Property Owner's or .Authorized Agent's Name � GV C-Vt�C- 0 g Z ACTION DATE By GC A OF COMPLIANCE WITf-I CODE OF FEDERAL FOR OFFICE USE ONLY REG ULATI 5 PART 61 OF TITLE 40 AND AQMD RULE 1 1403 PERM17 VPIRED I 1 [ L.31 SUBMITTEDASBESTOS NOTIFICATION TO PERMIT FINAL ` ❑ASB61105 NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF / PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: All required alarms, latches gates and fences which serve as part of a poofjspa barrier, shall be In place prior to approval to fill pool/spa & shall remain in place & be maintained for the life of the pool.