HomeMy WebLinkAboutF2019-0663 - PermitsS;Wt'Cx4 City of Newport Beach - Building Division IIIII�IIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIII II FIRE Permit: F2019-0663
aid'* 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 9 0 6 6 3 Project No : 2237-2017
Permit Counter Phone (949)644-3288 )
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°+cxrxu�'*° Inspection Requests Phone (949)644-3255
Job Address: 504 HAZEL DR NB
Description: SFR FUEL MODIFICATION INSPECTION
Inspector Area: 5
Legal Description:
N TR 673 BLK B LOT 36
Owner: 504 HAZEL DRIVE LLC
Contractor:
OWNER/BLDR -
Architect:
BRANDON CHRISTOPHER
Address: 504 HAZEL DR
Address:
Address:
151 KALMUS OR #G-1
CORONA DEL MAR, CA 92626
COSTA MESA CA 92626
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Phone:
Phone:
Phone:
e • ° s°
714-754-4040 State Lie: C034637
•
Applicant: LINSDAY BRANDON
Con State Lie:
OIB
Engineer:
DEIHIMI AMIR
m ° e ° •
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Address: 151 KALAMUS DR STE G7
Lie Expire:
Address:
4400 CAMPUS DR
° e
COSTA MESA CA 92626
Bus Lie:
NEWPORT BEACH CA 92660
°
• • °
Phone: 714-754-4040
Lic.Exp Date:
Phone:
949-752.1612 State Lie: C04;725J s o
a• °
Code Edit : 2016
Worker's Compensation Insurance
Designer:
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Type of Construction: VB
Carrier:
Address:
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Occupancy Group: R31U
-
Policy No:
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Added/New sq.ft. Bldg: 0
Expire:
Phone:
®
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Added /New sq. ft. Garage: 0
P P
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No of Stories: 0
Issued
Date: 1211812019
Special Conditions:
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No of Units : 0
Setback- Front:
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Flood Zone:
Rear.
6.0••`
°SO°
Bldg Sprinklers: N
Left:
Right:
FEES
Construction Valuation: $2,000.00
Building PC Fee :
$202.00
Fire Residential Alarm PC Fee :
$0.00
Records Management :
$0.00
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 as :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee .
$240.00
T TAL FEE:
$442.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance :
$442.00
PROCESSED BY:
OTHER D
ARTMENT:
ZONING APPROVAL:
FIRE APPROVAL:
PLAN
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID
N THE WEEKEND
/NER-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)
ction 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
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
Bions 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
femore 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,
siness 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
Irovements 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
ved for the purpose of sale).
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 nut
I 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).
am exempt from licensure under the Contractors' State License Law for the following reason:
my signaturepelowj acknowledge that, except for my perso r id Ce in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal
a structure that+ h eve built as an owner -builder if it has not onstructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business nd
fessions Code, is available upon request whe t ' pplicatip i ubmilted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Date
Wile of PrpderV(:wner or Authorized Agent //
:EASED COMTRACTOR'S DECLARATIO
Kebyaffirm under penalty of perjury that I am licensed undef pro sl ns of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
License No
tRERS' C®M4:kENSATION DECLARATION
Date
Contractor Signature
NCI FAILURE TO SBCURE 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
Of COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ibyreffirm under penalty of perjury one of the following declarations:
have and wllr 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 thr
4A4nce of VW worlll; for which this permit is issued. Policy No.
ave and w& naintain 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' compensatior
ince carrier and policy number are:
B of Agent
certify that, in the performanc��F the
if I should become subieff'tn a wO
of
Policy Number
Date
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
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thoseprions. / L// c, /J
n�f< o
:reby affirm under prinalty ofj th t there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name -ender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property
own/bbehI
have read this application andthe information I have
iI
agree to comply with all applicable city and county or a
aws relating to building construction.
I authorize representatives ofthis city orcountyto enter t
od property for inspection purposes.
nature of Property Owner or Authorized Agent
Print Propert Owner's or Authorized Agent's Name
ACRON DATE
B
DECLARATION OF COMPLIANCE WITH CODEOF
FEDERAL REGULATIONS PART 69OFTIRLE40AND
AOtMDRULE1403.
f SUBMfTI•EDASDESTOS NO71FICATION TO:
❑ EPA
❑ AOMD
PERMITEXPtRED
PERMITCANCELLED
PERMLTEXTENDED
❑ ASBESTOS HORRCARONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAt
r
i
CER-ITHCATEOF I �J °� I � � �\ Wali
d'Lp f61AI SIGNATURE.
OCCUPANCYISSUED �-W