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HomeMy WebLinkAboutF2021-0011 - Permits (3)1v „� City of Newport Beach - Building Division ' G 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 u a r'�L1Pii4�th. Job Address: 3 LINDA ISLE NB Inspector Area: 2 Owner: SHURKI SALIBA Address: 3 LINDA ISLE NEWPORT BEACH, CA 92660 Phone: 562-230-6842 Applicant: REZA JAMES Address: 1733 S DOUGLAS #G n ANAHEIM CA 926656 Phone: 714-980-08y3/ Code Edit : 2019 Type of Construdi Occupancy Gro� Added /New sq.ft. Added /New sq. ft. No of Stories: No of Units Flood Zone: Bldg Sprinklers: Construction Valuation VB R3/U 0 2 j 0 Y Building PC Fee : Building Overtime PC Fee: Building Extention Fee: Building Investigation Fee Fire Plan Check Fee: Fire Permit Fee : Building Permit Fee TOTALFEE: PROCESSED BY: ZONING APPROVAL: 'F2021--0011' J �t,� QI D cript OnnS, -FIRE ` 0059-20 1 Leg ascription: N 4003 LO� r��\\r0 Contract GUARD FIRE PR L&ON Addr -rA5 S HARBOR LVD #145 ' FULLERTON CA 92832 Phone.-, 714-980-1093 0 4` ��� e �000�ot i ADD 39 ebn State Lic. 1041 6 Lic Expire: 06/30/2022 Bus Lic: BT30074393 , „y Lic Exp Date- 02/28/2022 Worker's Compensation Insurance Carrier: FALL&LAKE FIRE Policy No FLA014781�i� Expire: - 07/18/2021 'IP/ Issued �Date 02/2512021 Setback' Front: Rear. ' Left' Rlgltn` o ;r� 6,000.00 yW- $2W4o pt� $0.0t1�� Q $0.00 O, $0.00 d$ / ® $0.00 FIRE APPROVAL: ( )`057 Architect: Address: Pt.Or 9\ress: FIRE Permit: F2021-0011 Project No : 0059-2021 Inspection Requests Phone (949)644-3255 2616) IP�C-7 State Lic: rState Lic: #G $0.00 Records Management: $2.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee: $0.00 Plan Check Fee: $217.00 Fee Due at Permit Issuance : $265.00 OTHER DEPARTMENT: PLAN CHECKED BY:: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) ind'e5ted belo y 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, olish, or reps 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 Li se Law (Chapter 9 ommencing 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 violati of Section 7031.5 b6n plicant 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 (_) all iness and Professions Code: The Contractors' State License Law does not apply to an owner of p "ovements are not intended or offered for sale. If, however, the building or improvement is so[ it 'oved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to co ct the e, ly to an owner of property who builds or improves thereon, and who contracts for th ojects i&t portions of the wo{ and the stmc a is not intended or offered for sale (Section 7044, WWI yees' or per Hal rt, builds or improves the property, provided that the W of c Ion, the Ow r-Builder 04 have the burden of proving that it was not built or and Professions CON- The Contractors' State License Law does not to the Contractors' StafhLLicense Law). J I am exempt from licensure under the Contractors' State License Law for the fokd6ving reason: " V Iy my signature below I acknowledge that, except for my personal residence in , sch 1 must have red e� or at IeastQtTe year prior to completion of th ell a structure that I have built as an owner -builder if it has not been constr ed in its ent!lm by Iicen need contradhis. I understand that a copy of the 'rofessions Code, is available upon request when this application is suviled or at th -following Web site:h ww.Ieginfo.ca.gov/calaw.htmi. 'signature of Property Owner or Authorized Agent o0 .ICENSED CONTRACTOR'S DECLARATION �� ` w hereby affirm under penalty of perjury that I am licensed unde provis�r�a hapter 9 (commencing with Section 7000 of Division 3 of th Buse( nd effect. ` icense Class - License .4 Date '' Contrac ig re IIORKERS' CCLIPENSATION DECLARATION ,//�� 'ARNING: FAILURE'C CECURE WORKERS' COMPENSAT40N COVERAGE UNLAWFOL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND Cyyr'¢L S UP �E DST OIL COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 6 OF THE LABOR CODE,_ INTEREST, AND ATTORNEY'S FEES hereby affirm under penalty of perjury GO of the folio ng declarations y� I hove and wi11 maintain a certificate of consent to self insure for workers' compensation, :issued by the Director of IndustrialJ'�elations as &I'Limance of the wo'k for which this permit is"issued.. Policy No. Section 7044 of the Business and my ycense is in full force ($100,000), IN ADDITION TO THE 3700 of the Labor Code, for ;bce and will maintain, workers compensation insurance as required by Section 3700 of the Labor Code for the pe111A once of the ork f X c is permit is issued. My workers' compen lance candir cnd policy number are: ler Policy Number xphat ia Da 1e of Agent Pho # Gerrity that, in the re. ormance bf thee" k fur which this permit. is Issued, I shall not employ any p°'erson in any manner as to be m act to the workers' compensation laws of California, and if I should uo act t t o e�om en tion provisions of Section 3700 ofthe tabor Code, I shall to comp) it provisio s1 hereby affirm underTpenalty of perjury :tatli is co Lion lending age %t'he pry�lfilance of th ork for Ic s permit is issued (Section 3097, Civil Code). ender's Name - �° Lt2e4pi's Address 'y my signature below, 1 certify to each of the to wing: ,v� �5 I am the property owner or authorized to act o the propert er' sit.. I have read this application and the information I ve pr correct�� I agree to comply with all applicable city and count r i'ir a c nd stat ws relati o buildi co uction. I authorize representatives of this city or coun t n a ovP7�� ti e y for ins cti urposes. signature of Property Owner or Authorized Agent . Y ri roperty Owners or Authorized Agent's Na/1rflA\X//\ .� to ACTION DATE Y L TION OF COMPLIANCE VIRTH CODE OF FOR OFFICE USE ON E L REGULATIONS PART 61 OF TITLE40 AND MD RULE 1403. ❑ISUBMITFEDASBESTOSNORFICAT(ONTO: ❑ EPA ❑ AQMD PERMIT EXPI RED -,t7.�22. /—� PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATEOF SIGNATURE: OCCUPANCYISSU€D