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Home My WebLink AboutF2020-0389 - Permitswuo City of Newport Beach - Building Division IIIIIIIIIIIII�IIIIIIIIII�IIIIIIIIIIIIIIIIIIII II FIRE Permit: F2020-0389 �' 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 0 0 3 8 9 Project No: 1724-2020 -, Permit Counter Phone (949)644-3288 9ea4 yr��' 9 9 Inspection Requests Phone (949)644-3255 Job Address: PL NB 55 Description: MFR IE KLERS (67) 29) INS DAHLIA Inspector Area: Legal Description: CORONA DEL MAR OT 3RBLK 231JNELY 10 FT NWLY 39XFT7 NC L lJ-717®ig ALLEY ADJ Building PC Fee : $217.00 Fire Residential Alarm PC Fee: $0.00 Records Management: Owner: 358 DAHLIA LLC Contractor: (FIRE PROTECTION Architect: $0.00 Address: 2855 E. COAST HWY #234 Address: 9559 NIGHTINGALE AVE Address: $0.00 NEWPORT BEACH, CA 92660 Building Investigation Fee: FOUNTAIN VALLEY CA 92708 - Phone: Phone: 714-234-9633 ry NO NST'RUCTI® State $0.00 Applicant: VU ANTHONY Con State Lie: 1038755 Engineer: 6 i-( tAtlY IYAN/®RK $0.00 Address: 9559 NIGHTINGALE AVE Lie Expire: 0413012022 m Address: FOUNTAIN VALLEY CA 92708 Bus Lic: BT30067240 Plan Check Fee : $217.00 Fee Due at Permit Issuance : Phone: 714.231-5108 Lie Exp Date: 05/3112021 Ph State Lie: �Code SMURDAY Edit: 2019 Worker's Compensation Insurance Designe . Type of Construction: V -B -SPR Carrier: EXEMPT Address: 9559 NIGHTINGALE AVE • ° ° Occupancy Group: R31U Policy No: no employees FOUNTAIN VALLEY CA 92708 Added /New sq.ft. Bldg: 0 Expire: Phone: 714-231-5108 Added/New sq. ft. Garage: 0 No of Stories: 3 Issued Date: 10/0912020 Special Conditions: iOCJ °,,,, No of Units: 0 Setback- Front: , Flood Zone: X Rear: oao°sa Bldg Sprinklers: Y Left: Right: - oocc o°ooe� PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL : ' APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION FEES Construction Valuation: $9,400.00 Building PC Fee : $217.00 Fire Residential Alarm PC Fee: $0.00 Records Management: $6.00 Building Overtime PC Fee: $0.00 Planning Counter Review: $0.00 Building Extention Fee : $0.00 Planning Zoning PC Fee: $0.00 Building Investigation Fee: $0.00 - $0.00 Fire Plan Check Fee: $0.00 Public Works PC Fee : $0.00 $0.00 Fire Permit Fee: $0.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Fee: $263.00 TOTAL FEE : $466.00 Plan Check Fee : $217.00 Fee Due at Permit Issuance : $269.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: PLAN CHECKED BY:: FIRE APPROVAL : ' APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -BUILDER 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 itern(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). 111, 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, 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). ❑ 1, 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 legal) 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:hftp://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm ypVgr I1*ally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7( 00) of DivisiX3ofaBusiness of sions Code, and my license is in full force and effect.lawas bass ,... License No Date or Signalur VIIQRKERS' I PEASATION DECLARATION A6IRNING!FAILORE TGSECUREWORKERS'COMPENSATION COVERAGE IS UNLAWFUL, ANO SHALL SDBJECT ANE LOVER TO CRIMINAL ENALTIES ANE5 UP TO ONE HONORED THOUSAND DOLLARS (f706,pea), IN ADDITION TO THE CbST 6P COMPENSAJPYDAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATT RNEY'S FE1 S. rErpbypffirm ulh ft.Rahalty of perjury one of the following declarations: 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 e of II7HA cIrli for which this permit is issued. Policy No. 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' carrier end policy number are: %.• s Policy Number Expiration Date r— in tRe if i of the work for which this permit is issued, I shall not employ any person in any manner so as to beco subject to the he.=kere-eempensation provisions of Section 3700 of the Labor Code, I shall forthwith comply k'Itlose provisions. 10 hereby affirm I(nder pWally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued Ender's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act a property owners behalf. I have read this application and the informati n I ave provided is correct. I agree to comply with all applicable city and cou ty ordinances and state laws relating to building construction. I authorize representatives of t is ci n t - ified property for inspection purposes. lionature of Propertv Owner or Au Ized Age Print Property Owner's or A orize Agent's Nam compensation laws of California, and 3097,1 Civil Code). Date ACTION DATE BY DECLARATION OF COMPLIANCE WAN CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMDRULE1403. PERMITEXPIRED ❑ t SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED P£RMITEXTENDED ❑ ASBESTOS M017FTCA170NIS NOT APPLICABLE TO PROPOSED DEMOLITION. -. PERMIT ANAL CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED