The URL can be used to link to this page

Home My WebLink AboutF2018-0643 - PermitsCity of Newport Beach - Building Division Permit: F2018-0643 IIIIINIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII IIFIRE 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 8 0 6 4 3 Project No : 2551-2018 Permit Counter Phone (949)644-3288 '��lrnep� Inspection Requests Phone (949)644-3255 Job Address: 128 VIA YELLA NI3 Description: DELTA 1, ADD (12) HEADS 2ND FLOOR (X2017-4078) REV18.2156 Inspector Area: 1 Legal Description: N TR 907 LOT 399 Owner: BROYLES JAMES P Contractor: DOMNICK NICHOLAS FIRE PROTECTION Architect: Address: 128 VIA YELLA Address: 16641 PINNACLE PEAK CT Address: NEWPORT BEACH, CA 92663 RIVERSIDE CA 92503 Phone: Phone: 951-687-1668 Phone: State Lic: Applicant: NICHOLAS DOMINICK Con State Lic: 682276 Engineer: Address: 16224 SPACE DR Lic Expire: 05/3112019 Address: MORENO VALLEY CA 92551 Bus Lic: BT30064964 Phone: 961-807-1347 Lic Exp Date: 10131/2019 Phone: State Lic: -- Code Edit: 2016 Type of Construction: V -B -SPR Worker's Compensation Insurance Carrier: WC EXEMPT Designer: Address: NICHOLAS DOMNICK`� 16224 SPACE DR Occupancy Group: R3/U .Policy No: (NO EMPLOYEES) MORENO VALLEY CA 92551 Added /New sq.ft. Bldg: 0 Expire: Phone: 951.807-1347 Added /New sq. ft. Garage: 0 No of Stories: 2 Issued Date: 12104/2018 Special Conditions: No of Units : 0 Setback- Front: Flood Zone: X Rear: Bldg Sprinklers: Y Left: Right: FEES Construction Valuation: $1,200.00 Building PC Fee: $202.00 Fire Residential Alarm PC Fee : $0.00 Records Management: $4.00 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 TOTAL FEE : $446.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $446.00 PROCESSED BY: .° + ++° OTHER DEPARTMENT: ZONING APPROVAL: <<.° ° "_i._'; ` " ,`�, PLAN CHECKED BY: FIRE APPROVAL: t` APPROVAL TO ISSUE: eco PERMIT EXPIFrES 'SBO i1A;YS AFTF-3 J$SUANCE OR LAST VALID INSPECTION OWNER -BUILDER DECLARATION I ' I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 toits 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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). ❑ 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 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 legaill 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:htlp://www.leginfo.ca.gov/caiaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 700 9) of Division 3 of the Business and Profession ode, rirTmy i'c se is in full force and effect. License Class License No Date Contractor Signatur WORKERS' COMPENSATION DECLARATION NARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: pp❑ 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 rmance of the work for which this permit is issued. Policy No. l have and wiaintain 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' compensatioi insurance carrier olicv number is of AgefZI� ��-fC� X=I,/e tom[ certify that, in the performance of jfla work for which this . if I should become subiect to th orkers' compellsatio. Date is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and lions of Section 3700 of the Labor Code, I shall forthwith comply with those provisiprtq. nature of Applicanrvv u CLARATION REG DI G CONSTRUCTION L ING AGENCY ;reby affirm under ifenalty of perjury that Were is a construction lending agency for the performance of the work for which this permit is Ider's Name Lender's Address 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 an tate laws r ting t building construction. I authorize representatives of this city or county to`enter t b - entified pr p tion purposes. nature of Pronertv Owner or Authorized ADent �/ rint Property Owner's or Authorized Agent ACTION DATE BY DtCLAHAIJUR Ur LUNIff"An �40AND FEDERAL REGtILATOP15.P4 670FTI, JLE AQMO RULE 1403.- • • . . • • : •:. PERMITEXPIRED ❑ t SUUAUTFEDUbESiOSAI&*CaTIPN.TO o PERMIT CANCELLED - ❑ EPA PERMITEXTENDED ❑ AOMD ❑ ASBESTOS N01ITICA170NIS NOT APPLICABLE TO PERMITFINAL PROPOSED DEMOLITION... CERTIFICATE OF SIGNATURE., • . . . •. . • • . • • i OCCUPANCYISSOED (Section 3097, Civil Code).