HomeMy WebLinkAboutF2019-0272 - Permits1Y City of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIIIIIIIIUIIIIIIIIIIIIIIIIII II
6 100 Civic Center Drive, Newport Beach, CA 92660 2 9 1 9 9 2 7 2
}� Permit Counter Phone (949)644-3288
Job Address: 2018 PORT PROVENCE PL N13
Inspector Area: 4
Owner: KALESNIK VITALI -
Address: 2018 PORT PROVENCE PIL
NEWPORT BEACH, CA 92660
Phone: 310-465.4586
Applicant:. STACEY/CA FIRE PROTECTION
Address: 647 CAMINO DE LOS MARES #108
SAN CLEMENTE CA 92673
Phone: 949-212-4417
Code Edit: 2016
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: 2
No of Units : 0
Flood Zone: X
Bldg Sprinklers: Y
Construction Valuation: $5,000.00
Building PC Fee: $202.00
Building Overtime PC Fee: $0.00
Building Extention Fee: $0.00
Building Investigation Fee : $0.00
Fire Plan Check Fee: $0.00
Fire Permit Fee $0.00
Building Permit Fee: $240.00
TOTAL FEE : $442.00
FIRE Permit: F2019-0272
Project No: 1053-2019
Inspection Requests Phone (949)644-3255
Phone:
949-212-4417 -
Phone:
Description: SFR FIRE SPRINKLERS (35) HEADS (X2018-3466)
Legal Description:
N TR 6624 LOT 16
Contractor:
CALIF FIRE PROT Architect:
Address:
647 CAMINO DE LOS MARES #108 Address:
Address:
SAN CLEMENTE CA 92673
Phone:
949-212-4417 -
Phone:
State Lie:
Con State Lie:
1016781 -
Engineer:
$0.00
Lie Expire:
08131/2020
Address:
$0.00
Bus Lie:
BT30063097
Lie Exp Date:
05131/2019
Phone:
State Lie:
'Worker's Compensation Insurance
Designer:
WEISE ANDY
Carrier:
STATE COMP
Address:
647 CAMINO DE LOS MARES #108
Policy No:
9217667
SAN CLEMENTE CA 92673
Expire:
09/1812019
Phone:
949-212-4417
Issued Date: 05/09/2019 Special Conditions:
Setback- Front
Rear
Left:
Right
e
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL
FEES
Fire Residential Alarm PC Fee :
$0.00 Records Management
Planning Counter Review:
$0.00
Planning Zoning PC Fee`.
$0.00
Public Works PC Fee:
$0.00 -
Public Works Traffic Plan Check Fee;.
$0.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance
���° atla .• (.y e. ••.-OTHER•DEPkRTMENT:
a 6. tle (f
4 a m a° •„(PLAFI I%HEtAD BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DA Y& AFTER ISSUANCE CIR LAST•'VALfD INSPECTION
roe. a• u mama am
$0.00
$0.00
$0.00
$442.00
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a
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)
lection 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
is 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
'rofessions 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
of more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved for the purpose of sale).
1 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
pply 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:
ly 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 legal
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
ignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
herebyaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Protessioris Code, a my license is in full fort
nd effect. ii 11
!cense Class License No Date)J.61141 Contractor Signatu
CORKERS' COMPENSATION DECLARATION
'ARNING: 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 ($100,0001, IN ADOITIO THI
OST 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:
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.
have and will maipta. 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' compensa
Trance carrier and olidnumber are: /�
vier Ir. _ \ Poli ek I� Expiration Date
ne of Agent . � Phone #
certify that, in the performance of the vprk for which this permit is issued, I s 1 not employ any person in any manner so as to become subject to the workers' compensation laws of California, and al
if I should become ssuu/act (lEthe wor r ' ensation r/p1vlsi/o�s� of Se l0 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date
iature of Applicant 7� \��- p/ \/ l P Y Date pV
hereby affirm under penalty of perje that there is a construction lendin�jency for the performance of the work for whichthis permit is issued (Section 3097, Civil Code).
anders Name 1i// 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 provided is correct.
I agree to comply with all applicable city and county ordinaricas and state laws relating to building constru an.
I authorize representatives of this city or county�to 4te(1 ove-i0e Ie _pwZerty for)ripp ionWrOoses. e / .rl , r n n 13
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