HomeMy WebLinkAboutF2020-0023 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII III
i4 .. 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 0 0 0 2 3
Permit Counter Phone (949)644-3288
Job Address: 915 TILLER WAY NB
Inspector Area: 4
Owner: BEARD LESLIE & JAY
Address: 915 TILLER WAY
CORONA DEL MAR, CA 92625
Phone:
Applicant: ARREOLA SERGIO
Address: 6983 BROWNING RD
HIGHLAND CA 92346
Phone: 949-674.7151
Architect:
Code Edit : 2016
6983 BROWNING RD
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:
1
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
FIRE Permit: F2020-0023
Project No : 0194-2020
Inspection Requests Phone (949)644-3255
Description: SFR FIRE SPRINKLERS 29 HEADS (X2019-1517)
Legal Description: N TR 6228 LOT 89
Contractor:
SERGIO ARREOLA
Architect:
Address:
6983 BROWNING RD
Address:
$5,000.00
HIGHLAND CA 92346
Phone:
909.674-7151
Phone:
Con State Lic:
1022721
Engineer:
Lic Expire:
01/3112021
Address:
Bus Lic:
BT30063414
Building Extention Fee :
Lic Exp Date:
05130/2020
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
NO EMPLOYEES
Address:
Policy No:
Fire Plan Check Fee:
$0.00
Expire:
$0.00
Phone:
Issued Date: 01/30/2020
$0.00
Special Conditions:
Setback- Front:
Building Permit Fee:
Rear:
Left:
TOTAL FEE :
$444.00
Right:
$0.00 Fee Due at Permit Issuance :
$444.00
State Lic:
State Lic
TAD HENRY
1401 N BATAVIA ST
ORANGE, CA 92867
714-398.9645
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ZONING APPROVAL: °, ° • p PLANC SiECILEd BYa�
FIRE APPROVAL: VW _ APPROVAL TO ISSUE:
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PERMIT EXPIRES 180 DAYS AFTER ISS t b4NCO pR IdSi. W7,'7„!@fS'EtiT/ON
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FEES
Construction Valuation:
$5,000.00
Building PC Fee :
$202.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
$2.00
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:
$240.00
TOTAL FEE :
$444.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$444.00
PROCESSED BY: _ \� • °o • p •OTHF,lk PF,F%PTMgMP: <, `
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ZONING APPROVAL: °, ° • p PLANC SiECILEd BYa�
FIRE APPROVAL: VW _ APPROVAL TO ISSUE:
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PERMIT EXPIRES 180 DAYS AFTER ISS t b4NCO pR IdSi. W7,'7„!@fS'EtiT/ON
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7WNER-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).
❑ 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,
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 legally
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 fallowing Web site:http://www.leginfo.ca.gov/calaw.htmi. Date
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professio od , and my license is in full force
and effect. Date 6T' ontractor Signature
License Class License No
If
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRE HOUSAND 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:
❑ 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 th,
performance of the work for which this permit is issued. Policy No.
I have 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' compensatiol
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
I certify that, in the performance of he work 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 agre
of I should become�subject w?&IA! compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applica
CLARATION RE N=LENDINGY
;reby affirm and penalty pernding agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
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 and state laws relating to building construction.
I authorize representatives of this city or county t ,enter the above -identified property for inspection purposes. - r
nature of Property Owner or Authorized Agenf NZ Print Property Owners or Authorized Agent's Name ..a 'L
ON Oc rnaADI 1ANrrFMnTH rnnF nF I FOR OFFICE
ACTION I DATE
PERA41TEXTENDED
DECLARATI
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CERTIFICATEOFI • _• • kl
OGCUPANCYISSUED ••.
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NOIIFICATION TO:
IS NOT APPLICABLE TO