HomeMy WebLinkAboutX2015-0209 - PermitsCity of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111 COMB Permit: X2015-0209
04 0 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 5 0 2 0 9 Project No
e
F yryry Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
�x«cgs* Combination Type - SFP PLUM Issued Date : 01123/2015
Inspection Area : 6
Job Address:
7 SARACENO NB
Description:
SFR - REPIPE W/PEX
Legal Desc.:
Owner:
BASSIRPOU GREG
Address:
7 SARACENO
NEWPORT COAST CA 92657
Phone:
Applicant:
ULTIMATE BUILDERS INC
Address:
19326 VENTURA BLVD #201
TARZANA CA 91356
Phone: 818-342-2927
Code Edit : 2013
Type of Construction: VN
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added (New sq. ft. Garage: 0
No of Stories: 2
No of Units : 7
Bldg Height: 0
Bldg Sprinklers:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE/CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED
Contractor:
ULTIMATE BUILDERS INC
Address:
19326 VENTURA BLVD #201
TARZANA CA 91356
Phone:
818-342-2927
Con State Lic:
927892
Lic Expire:
01/31/2015
Bus Lic:
BT30044924
Lic Exp Date:
10/31/2015
Worker's Compensation Insurance
Carrier:
EVEREST NATIONAL INS
Policy No:
7600012064131
Expire:
09/15/2015
Building Setbacks Rear: /
Front: /
Left: /
Right: I
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic.
State Lic:
Special Conditions: NO PEX ALLOWED THROUGH
FIREICOOMMON WALL
Fire Hazard Zone : N
Construction Valuation:
$5,000.00
Building Permit Fee:
$144.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee:
$0.00
Additional Fee:
$0.00
Plan check Fee
Overtime Plan Ck:
$0.00
Fair Share
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans
Record Management :
$0.00
Grading Permit Fee.
$0.00
In -lieu Housing Fee
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department -
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access:
$0.00
P/W Plan Check:
$0.00
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee :
$
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$14.40
TOT/(L FEE: $1
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due atP_ermit Issuance : $159.40
PUBLIC WORKS APPROVAL: i
PLAN CHECK BY:
APPROVAL TO ISSUEi .
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) Indic
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, dem
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Secti
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 tl
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through E
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp
improved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
apply to an owner of property who builds or improves thereon,. and who contracts for the projects with a licensed Contractor
❑ 1 am exempt frorr licensure under the Contractors' State License Law for the following reason:
By my signature oelow I acknowledge that, except for my personal residence in which I must have resided for at least one y
I SPII P ^,tructure;hat I lave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I urn
Professions Code, is .available upon request when this application is submitted or at the following Web site:http://www.leginl
Gignature of Property Owner or Authorized Agent
LICENSED CONTPACTOR'S DECLARATION
III hereby affirm under ,enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SepSK 7000) of
,and effect. License Class License No
IV1(01?KERS' :.GMPdNSATION DECLARATION
11NC4" I'IG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL'
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I' hcreb} affirm ender penalty of perjury one of the following declarations:
I 1 heie and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
ante of'.hc wort: for which this permit is issued. Policy No.
TI< I ha e and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
insure ce carrier and policy number are:
Policy Number
of Agent
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner
t, if I should become subject to the workers' compensatig-provisions of Section 3700 of the Labor Code, I shall forthwit
9tu re of Applicant !�
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
Ireby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for whic'.
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 constructioni
authorize representatives of this city or county to enter the above -identified property f spedio purposes.
ature of Property Owner or Authorized Agent �``-�� n roperty Owner's or Au
d below by the checkmark(s) I have placed next to the applicable items)
.h, or repair any structure, prior to its issuance, also requires the applicant for
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
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
and Professions Code: The Contractors' State License Law does not
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
/calaw.html.
Date
in 3 of t�siness and Professions Code, and my license is in full force
r o actor Signature
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
as to become subject to the workers' compensation laws of California, and
Imply with those provisions. ^^
permit is issued (Section 3097, Civil Code).
Agent's Name d �i fC, rt -fan d ae
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