HomeMy WebLinkAboutF2021-0124 - Permitsw City of Newport Beach - Building Division *F2021 -0124*
G 100 Civic Center Drive, Newport Beach, CA 92660
H =_ Permit Counter Phone (949)644-3288
r .
Job Address: 2961 CLIFF DR NB
Inspector Area: 3
Owner: HALLER DAVID
Address: 2961 CLIFF DR
NEWPORT BEACH, CA 92663
Phone
Applicant: CASEY MONTY
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone: 714-476-5370
Code Edit: 2019
Type of Construction:
VB
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
FIRE Permit: F2021-0124
Project No: 1598-2020
Inspection Requests Phone (949)644-3255
Description: SFR *ADDITIONAL SCOPE* ADD 1 HEADS
1598-2020
Legal Description:
FIRST ADD TO NEWPORT HEIGHTS
LOT BLK Z PARK
Contractor:
FIREPROOF FIRE PROTECTION
Architect:
Address:
1101 KINGSTON DR
Address:
LA HABRA CA 90631
Phone:
714476-5370
Phone:
State Lie:
Con State Lie:
876004
Engineer:
Lie Expire:
04/30/2022
Address:
Bus Lie:
BT30040107
Lie Exp Date:
08131/2021
Phone:
State Lie:
Worker's Compensation Insurance
Designer:
CASEY MONTY
Carrier:
SECURITY NATIONAL INS
Address:
1101 KINGSTON
Policy No:
SWC1325710
LA HABRA CA 90631
Expire:
02115/2022
Phone:
714-476-5370
Issued Date: 0410512021
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
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FEES
Construction Valuation:
$1,100.00
Building PC Fee:
$0.00
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 Fee:
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$263.00
TOTAL FEE :
$263.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$263.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
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 items)
(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 Iicensure 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 fivehundreddollars ($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 Iicensure 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, 1 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 following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CQV;.RACTOR'S DECLARATION
i hereby affimN Lnilgrlienalty of perjury that I am licensed under provisions of Chapter 9 (commencing wi ction 7000) of Division 3 of the Business an rofessions Code, and my license is in full force
,and effect. �,
(LiddhSg Class'": License No Date 1 Contractor Signature
WORKERS' COMPENSATION DECLARATION
=NAftt dill: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU DRED THOUSAND DOLLARS 15100,0001, IN ADDITION TO THE
COST OF COMPE NSA11811, PAMAGEs AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
l Aaregpaffirm undafpenally of perjury one of the following declarations:
U,I j;ve andWil 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(
e ormance of4he Mrk for which this permit is issued. Policy No.
.tmie 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' compensatior
i s carrier and policy number are:
egigr. `. . Policy Number Expiration Date
of Agent .:... :
certify that, in the perfo mance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to he workers' compensation laws of California, and
, if I should become I ject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those profisidi s.
of
CLARATION REGAgDIN ONSTRUCTION LENDING AGENCY
;reby affirm under p`inalty of piRjuny that there is a construction lending agency for the performance of the work for which this permit is
lder'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 c ordinances and state laws relating to building construction.
1 authorize representatives of this city, or count enter the above -identified property for inspection purposes.
nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agenl
3097, Civil Code).
1l
ACDON
DATE
BY
DECLARATION OF COMPLUI CE IMTR CODE OF
FOR OFFICEUSE ONLY
FEDERAL REGULATIONS PART 01 OF T17L€40 AND
AQMD RULE 1403.
PERMITEXPIRED
❑ ISUBMNTEDASB€STOSNOTtFICAT/ONTO.,
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
ASBESTOS NOTIRCA17ON IS NOT APPLICABLE TO
PROPOSEDD€MOUTION.
PERMIT FINAL
CERTIFICATE OF
SIGNATURE:
OCCUPANCYfSSUED