HomeMy WebLinkAboutF2021-0387 - PermitsoyofNewport Beach
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Permit Counter Phone (949)644-3288
Job Address: 389 23RD ST NB
Inspector Area: 1
Owner: DOBSON JAMES
Address: 389 23RD ST
NEWPORT BEACH, CA 92660
Phone:
Applicant: SCHROEDER TONY
Address: 1325 N RED GUM #10
ANAHEIM CA 92806
Phone: 714-630-3916
Code Edit: 2019
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:
2
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
Construction Valuation: $4,900.00
Building PC Fee :
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Fee
Fire Plan Check Fee:
Fire Permit Fee :
Building Permit Fee
TOTAL FEE
PROCESSED BY:
FIRE Permit: F2021-0387
Project No : 2029-2021
Inspection Requests Phone (949)644-3255
Description: SFR FIRE Oj21NKLERS 15 HEADS (X2021-1518)
Legal Description: P BK 273 PG 45 PAR 1
Contractor:
ACT FIRST FIRE PR�QQTECTION
Address:
1325 N RED GUMWREET
#10
ANAHEIM CA 928
Phone:
714-630.3916
Con State Lic:
830883
r�P€
Lic Expire:
03/31/2022
Bus Lic:
BT30030288
Lic Exp Date:
11/30/2021
Worker's Compensation Insurance
t c
Carrier:
SECURITY NATIONAL
Policy No:
SWC1188764
[[�
Expire:
03/12/2022
Issued Date: 09/02/2021
Setback- Front:
Rear:
Left:
Right:
$222.00
$0.00
$0.00
$0.00
$0.00
$0.00
$269.00
$493.00
ZONING APPROVAL: '� • `� - e
FIRE APPROVAL: m" °,' "4�
t
FEES
Fire Residential Alarm PC Fee
Planning Counter Review:
Planning Zoning PC Fee
Public Works PC Fee :
Public Works Traffic Plan Check Fee;
Plan Check Fee :
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
®
ioecial Conditions:
M
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
State Lic:
State Lic:
SCHROEDERTONY
1325 N RED GUM #10
ANAHEIM CA 92806
1 V
Records Management:
Fee Due at Permit Issuance
bv•
PERM? EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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Hd ® ^ P � 0i• •�•
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$2.00
$0.00
$0.00
$493.00
$2.00
$0.00
$0.00
$493.00
FNER-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
fessions 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
more than five hundred dollars ($500).
J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions
usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throul
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc
nproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra(
I am exempt from licensure under the Contractors' State License Law for the following reason:
y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least or
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I
'rofessions Code, is available upon request when this application is submitted or at the following Web site: http://wvwd.Is
ignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se tion 00(
nd effect.
icense Class License No D 1
COMPENSATION DECLARATION
NG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO'CF
OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director
ormance 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
lance carrier and policy number are:
ier Policy Number
le of Agent
certify that, in the performs a of the work for w' h this permit is is edTshall not employ any person in any
if I should become subjec o theep wor rs''tcom ation pro " tnts, of Section 3700 of the Labor Code, I shall
Iature of ADDIICant i N I Xl Y A M i
work, and the structure is not intended or offered for sale (Section 7044,
ployees' or personal effort, builds or improves the property, provided that the
ion, the Owner -Builder will have the burden of proving that it was not built or
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
Date
Division 3 of the Business and r I essions "ode, a my lice s(/ee� is in ffuull force
_!-_ ContractorSignatur ,II 7
IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
Industrial Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
so as to become subject to the workers' compensation laws of California, and
i comply with those provisionp. i
I hereby affirm under penalty/of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sibcdon 3097, Civil Code).
Lender's Name Lender's Address
By 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 he
provided is correct.
I agree to comply with all applicable city and coun y or finances and state s relating to building construction.
I authorize representatives of this city or cou t en r the ab . ntif d property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name
ACTION
DATE
BY
DECLARATION OF COMPLIANCE MTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40AND
AQMD RULE 1403. 1
•.
PERMITEXPIRED
[31SUBMITTED ASBESTOS NOTIFICATION TO:.
❑ EPA •
❑ AQMD
..
a �•• ^• •••
• • �� : •� °•
'• `.' •• ,•� •�
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
•° ° m
PERMIT FINAL
0 T/L
CERTIFICATEOF
I
SIGNATURE:
OCCUPANCYfSSUED