HomeMy WebLinkAboutF2021-0544 - Permitsn'I City of Newport Beach - Building Division Ilfl'�IIIIIIIIIIIIIIIII�II�IIIIII�III II
,p 100 Civic Center Drive, Newport Beach, CA 92660 II 4 2 0 2 1 0 5 4 I
Permit Counter Phone (949)644-3288
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Job Address: 2300 MESA DR NB
Inspector Area:r f1
VL4
Owner: GLIDEWELL FAMILY TRUST
Address: 2300 MESA DR
NEWPORT BEACH, CA 92660
Phone:
Applicant: SOLT EMANUEL
Address: 22046 CELES ST
WOODLAND HILLS CA 91364
Phone: 818-963.2667
Code Edit : 2019
Type of Construction:
V-B
Occupancy Group:
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: F2021-0544
Project No: 2644-2021
Inspection Requests Phone (949)644-3255
Description: SFR INSTALL 3" X 5' FIRE RISER X 2toal - D (ADS
Legal Description:
IRVINE SUB LOT 152 BLK 51 FOR OF LOT
Contractor:
UNI FIRE PROTECTION INC
Architect:
Address:
22046 CELES ST
Address:
WOODLAND HILLS CA 91364
Phone:
818-348-1616
Phone: State Lie:
Con State Lie:
692497
Engineer:
Lie Expire:
08/31/2023
Address:
Bus Lie:
BT30047752
Lie Exp Date:
10/31/2022
Phone: State Lie:
Worker's Compensation
Insurance
Designer: SHAHNAM SALEH
Carrier:
PREFERRED PROF INS CO
Address: 22046 CELES ST
Policy No:
ON1195801
WOODLAND HILLS CA 91364
Expire:
10122/2022
Phone:
Issued Date: 1110912021
Special Conditions:
Setback- Front:
Left:
Right:
b I bl- ll�✓ — ���
FEES
Construction Valuation:
$5,500.00
Building PC Fee :
$222.00
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 :
$269.00
TOTAL FEE :
$493.00
Plan Check Fee :
-$0.00 Fee Due at Permit Issuance :
$493.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTa82R DgPARTMENT:
a
PLAOCH&KED BY::
° °
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTkR SSrLANC-Ea OR i'„4ST VALID INSPECTION
°°° BB9 B • •Ya •atl i0i
DWNER-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 U all of or U 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 Iegall
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 afthe 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.htmi.
Signature of Property Owner or Authorized Agent Date
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 P Ions Code, d ense is in Lit force
and effect.
License Class License No Date (�l1 �"'r Contractor Signat r
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 HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for IN
krrormance of the work for which this permit is issued. Policy No.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
rance carrier and policy number are:
Number
ie of Agent
certify that, in the performanspeof the work for
if I should become subjec gj0?workers„co,
Date
d, I shall not employ any person in any manner so as to become subject to the
Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Late
CLARATION REGAR CONSTRUCTION LENDING AGENCY
Jreby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issue (;
ider's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ' antes a fate a ing to building construction.
I authorize representatives of this city or county to ov a pr a or inspection purposes.
naNire of Pronerty Owner or Authorized I Print Property Owner's or Authorized Agent's Name
3097, Civil Code).
laws of California, and
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WTH CODE OF
FOR OFFICE USE ONLY
,F Fj1!L REGULATIONS PART 51 OF TITLE40 AND
AQ� b.'fi)/LE Vil • °
PERMfTEXNRED
C] I$UBPoJITf'EPAS&STOSPO71F;4!ATION' TO:.
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PERMIT CANCELLED
PERMITEXT€NDED
❑ ASBESTOS N071€ICATION IS NOT APPLICABLE TO
PIJQPOS EDDEMOUTION.
° ° • • • e. s°• ••
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUEO
SIGN3iTUR ' e • ; e