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Home My WebLink AboutF2021-0163 - Permits0 City of Newport Beach - Bpilding Division IIIIIIIIIII�IIIII�IIIIIIIIIIIIIII II 100 Civic Center brive, Newport Beach, CA 92660 F 2 0 2 1 0 1 6 3 Permit Counter Phone (949)644-3288 Job Address: 22 LINDA ISLE NB Inspector Area: 2 Owner: SMITH GEORGE Address: 22 LINDA ISLE NEWPORT BEACH, CA 92660 Phone: Applicant: KELLY SEAN Address: 10141 THESEUS DR HUNTINGTON BEACH CA 92646 Phone Code Edit: 2019 Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: No of Units Flood Zone: Bldg Sprinklers: Construction Valuation: FIRE Permit: F2021-0163 Project No : 0964-2021 Inspection Requests Phone (949)644-3255 Description: SFR FIRE SPRINKLERS (X2020-1400) 75 HE1L0�dd� � Legal Description: N TR 4003 LOT 22 �a Contractor: KELLY FIRE PROT INC Architect: 0 , Address: 10141 THESEUS DR Address: Phone: HUNTINGTON BCH CA 92646�� 714-907-7586 Phone: State Lie: �� Con State Lie: 878823 Engineer: Lie Expire: 08131/2021 Address: F4 Bus Lie: Lie Exp Date: BT30070761 0113112022 WW,�., Phone: Stalt �e Worker's Compensation Insurance V-BSPR Camer: AMERICAN FAM HOM INS R3/U Policy No: 2EA5WC000024603 0 Expire: 04/1112022 0 2 Issued Date: 05103/2021 0 Setback- Front: Rear: Y Left: Right: Building PC Fee : Building Overtime PC Fee: Building Extention Fee : Building Investigation Fee Fire Plan Check Fee: Fire Permit Fee : Building Permit Fee TOTALFEE $3,400.00 $217.00. $0.00 $0.00 $0.00 $0.00 $0.00 $263.00 $482.00 FEES Fire Residential Alarm PC Fee Planning Counter Review Planning Zoning PC Fee Public Works PC Fee: Public Works Traffic Plan Check Fee; Plan Check Fee : PROCESSED BY: 3 q N 6 90 B ZONING APPROVAL: FIRE APPROVAL: �Ll Designer: Address: Phone: Special Conditions: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: GRISSOM DAVE 645 N ECKHOFF ST ORANGE CA 92868 Records Management Fee Due at Permit Issuance �e a oflo 6 4 N PE104IT t: PIR,ES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 9pN QbW N R B5i 9P bPB N $2.00 $0.00 $0.00 $482.00 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 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). J I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throuc nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70, pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrac I am exempt from lioensure 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 or ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.le lignature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700C ,nd effect. , -, .icense Class License No Date 15- 12- .2 COMPENSATION DECLARATION ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the Aetion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year prior to completion of the improvements covered by this permit, I cannot nderstand that a copy of the applicable law, Section 7044 of the Business and Date of Division 3 of the Business and Professns Code, an my license is in full force / Contractor Signatu ,LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOL ' 0D,000), IN ADDITION TO THE hereby affirm under penalty of perjury one of the following declarations: 4I 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 e rmance 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 the performance of the work for which this permit is issued. My workers' compensa Isu nce carrier and policy number are: to of Agent certify that, in the performance of the work for , if I should become subject to)fle workers' co, of Policy Number this permit is issued, I shall not employ any person in any ation provisions of Section 3700 of the Labor Code, I shall IECLARATION REGARDING CONSTRUCT N LEND AGENCY hereby affirm under penalty of perjury that tIfere is a const uction lending agency for the performance of the work 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 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 toe er the abgv$-identified property for inspection purposes. Date so as to become subject to the workers' compensation laws of California, and i comply with those provisions. this permit is issued (Section 3097, Civil Code). D_ IlSignature of Property Owner or Authorized Age rlt� 1 ✓c'" Print Property Owners or Authorized Agent's Name I Y Date 11 ACTION DATE BY DECLARATION OF COMPLIANCE MTR CODE OF FOROFFICEUSEONLY FEDERAL REGULATIONS PART 61 OF. WL&39AND. `. . AWL, RULE 1403. I .+ El SUBMITTED ASBESTOS N011 MAN() TO.- . •.• .` . ❑ EPA ❑ AQMD • �• PERMITEXPIRED PERMIT CANCELLED PERWITEMTENDED ❑ ASBESTOS NOTIFICATION IS NOT APfLIBLCAE TO PERMITFINAL PROPOSED DEMOLITION. .` •`• •', 6`� �`` �•� CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED ao�