HomeMy WebLinkAboutF2021-0299 - Permits�;NtYrr4, City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 56 TIMOR SEA NB
Inspector Area: 5
Owner: INDRANI GILL
Address: 56 TIMOR SEA
NEWPORT COAST CA 92657
Phone:
Applicant: WEISE STACY
Address: 647 CAMINO DE LOS MARES
SAN CLEMENTE CA 92673
Phone: 949-770-5371
Code Edit: 2019
Type of Construction:
V-B-SPR
Occupancy Group:
R3
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
0
No of Units :
0
Flood Zone:
X
Bldg Sprinklers:
Y
2i21 iiiiigg
Descridtion: RES 9PE SPRINKL EP:
ADD 2 HEADS
Legal Description:
Contractor:
CALIFORNIA FIRE PROTECTION
Architect:
Address:
647 CAMINO DE LOS MARES #108
Address:
SAN CLEMENTE CA 92673
Phone:
949-212-4417
Phone:
Con State Lic:
1016781
Engineer:
Lic Expire:
08/31/2022
Address:
Bus Lic:
BT30063097
Lic Exp Date:
0513112022
Phone:
Worker's Compensation
Insurance
Designer:
Carrier:
OHIO SECURITY
Address:
Policy No:
XWS60230423
Expire:
0911812021
Phone:
Issued Date:
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
FIRE Permit: F2021-0299
Project No : 1633-2021
Inspection Requests Phone (949)644-3255
State Lic:
State Lic:
FEES
Construction Valuation:
$3,000.00
Building PC Fee :
$0.00
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
$0.00
Building Investigation Fee :
Fire Plan Check Fee:
$0.00
$160.00
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 :
$431.00
Plan Check Fee :
$431.00 Fee Due at Permit Issuance :
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE: III
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
UWNtK-ti UILUtK UtGLAKAI IUN . - _ _ ,
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State I icPnse 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 oermi. to construct, liter, 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 prop;sions cf the Contractor-' Statc Sicense 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 compEn,at'on, will do (_) ell 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 aopiy (o an unner of propel,y wl,o, 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 (rr,Iprovement is. sold within one year at 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 following Web site:http://www.leginfo.ca.gov/calaw.html.
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 Busine(n r fessi s Co ,and 'tense is in full force
and effect.
License Class - W License No �O I D ` Date - - Contractor Signatur
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA S ($10 ,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
3erformance of the work for which this permit is issued. Policy No.
41 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio
nsurance Cal 'ier and poli y number are: `, r o j
3arrier )' Policy Number X ti� ��Q U �f—I ''�' Expiration Date 01 ZO / Zn
Name of Agent Phone #
�l certify that, in the perfo a e the work for is this ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
,hat, if I should becomes bje to worke s' cc sat/i$,nR�Irovisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions.
signature of Applicant _ / 1 n�ro / �� � - )
Ireby affirm under penalty of perjury that there is a c nstruc on lending 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 to enter the above -identified property for inspection purposes.
nature of Property Owner or Authorized Agent. Print Prcoerty Owner
or Authorized
Date
AC77ON
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
AQMD RULE 1403,
PERMfTEXPdRED
❑ 1 SUBMITTED ASBESTOS N077FICATION TO:
❑ EPA
❑ AOMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS N077FICA77ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FWAL
..
CE4TrFICATECF
OCCUPANCI`ISSUED
SfGNATURE: