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HomeMy WebLinkAboutF2021-0011 - PermitsI* City of Newport Beach - Building Division ������7�10 ��'j�N���� FIRE Permit: F2021-0011 a G 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0059-2021 Permit Counter Phone (949)644-3288 ) 75 °++' �.�"�„ Inspection Requests Phone (949)644-3255 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 DOUGLASS RD #G ANAHEIM CA 928056 Phone: 714-980-0817 Code Edit : 2019 Type of Construction: VB Occupancy Group: R Added /New sq.ft. Bldg: Added /New sq. ft. Gara No of Stories: No of Units: b° Flood Zone: Bldg Sprinklers: Y Construction Valuation: 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: FIRE APPROVAL: 0 0 Legal Description :JWTR 40QkL11T33( 0��4I v- Contrac GUARD \\FIRtECI Add 1545 S HAf R BLVD ,FULLERTON CA 92W hone. / 714 980 1093 ,4C Con to Lic: 104, 1). Li xpire 0613012022 us Lic. BT30074393 % Lic Exp Date: 02/28/2022 Worker's Compensation Insurance Carrier. - FALLS LAKE FIRE Policy No: FLA014781 rj ``. Expire: 07/1812021 Issued Date: - 02/25/2021 v Setback- Front: Rear Left: Right: FEES 217.00 Are idential $0.00 + mg Counh $o.00 �� 0.00� � �C Public arks PI �00\ Pu c Works 3.00 / =1 $482.00 1PI C ck Fee: 8-2616) Architect: Address: Phone: State Lic: E i z P ne: State Lic: � ��5fgner: PA gU13T dress: 3SD GLASS RD #G ANAH ,;K 928056 0 1� 1 Phone. "61)ecialCondi ns . DELTA 1 ADD 2 HEADS Q' Fee $0.00 Records Management : $2.00 $0.00 $0.00 $0.00 $0.00 $0.00 Check Fee; $0.00 $482.00 Fee Due at Permit Issuance : $0.00 OTHER DEPARTMENT: PLAN CHECKED BY:: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION WNER-BUILDER DECLARATION I I I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated - ow by th heckmark(s) I have placed next to the applicable items) ;action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demo or repair any ucture, prior to its issuance, also requires the applicant for ie permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State Licens w (Chapter 9 (com ncing with Section 7000) of Division 3 of the Business and rofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of, f ction 7031.5 by any Eopli Pit for a permit subjects the applicant to a civil penalty of )t more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their Sole compensation, will do (_) all of or ortions of the work,no structure i of intended or offered for sale (Section 7044, usiness and Professions Code: The Contractors' State License Law does not apply to an owner of prop who, t emplo or personal ort, lids or improves the property, provided that the nprovements are not intended or offered for sale. If, however, the building or improvement is sold w one ye t ompOleGl�¢ a Owner-B ' er will h the burden of proving that it was not built or nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to const � the prokq.e®� ctio 7Q�4, Business a Professions Code: T Contractors' State License Law does not pply to an owner of property who builds or improves thereon, and who contracts for the leas with aW�ensed�e�ftractor pursue o the Contractors' State Li nse Law). I am exempt from licensure under the Contractors' State License Law for the fol Ing reason: y my signature below I acknowledge that, except for my personal residence in Ich 1 must h e resided foKat leastop ar prior to completion of the improveme covered by this permit, I cannot legal ell a structure that I have built as an owner -builder if it has not been constr d in its entir by licensed contract understand that a copy of the applicable law, ction 7044 of the Business and 'rofessions Code, is available upon request when this application is su ad or at the lowing. VAlb,site:http:i(".leginfo.ca.govlcalaw.html. signature of Property Owner or Authorized Agent D .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed u prR,ialrlq hapteF 9 (commencing with Section 7000) of Division 3 of the Business ssions Code, d my license is in full force Ed effect. .icense Class Lice No Date Contractor S afu VORKERS' COMPENSATION DECLA N 61 IARNING: FAILURE TO SECURE WORKERS' COMP TION COVERA IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINEibl` To �PUNDRED THOU D DO I$10 .0001, IN ADDITION TO TH :OST OF COMPENSATION, DAMAGES AS PROVI FOR IN SECTI N 1706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES hereby affirm under penalty of pe ' one of the f wing declarations:, I have and will maintain ertiflcateet ,cDnsent to self insure for workers' compensation, Issued by the Director of industral tZafi�ons as provi d fore cti 700 of the Labor Code, for tl ertortnance of the work for. 'ch thi�H�tlit is issued. Policy No. _ 0 �'t\ �l have and will maintain wo ' compen on insurance, as required by Section 3700 of the Labor Code or the-perfor ilce of thew for hitt�i flit "it is issued. My workers' compensati isurance carrier and policy numb are: :arrier Policy Number" irationte lame of Agent '. _ Phone 71 certify that, in the performance of the ork for which I permit is issued, I shall not employ any person in any manner s s to bec a act to the workers' compensation laws of California, and agl hat, if I should become subject to the work W corq sa on provisions of Section 3700 Df the Labor Code, I shall forth comply a provisions. Signature of Applicant e £i Date )ECLARATION REGARDING CONSTRUCTIO LEN ' - ENCY hereby affirm under penalty of perjury that there a con ruction lending agency for the performanp�A w k for Ich Bfis permit is issued (Section 3097, Civil Code). _ender's Name Lender's Ad lips 3y my signature below, I certify to each of the follow'il I am the property owner or authorized to act on the rope behalf` I have read this application and the information I hav rovi s correct. \� I agree to comply with all applicable city and county o ances and state laws rel g to buifl ' g truction. I authorize representatives of this city or county to enter above -identified party for J pe ' n purposes. ;inmafi ire of Prnoertv Owner or Authorized Agent ^ G°, • / Rrifitt Property Owner's or Authorized Agent's Name Date AcnoN DATE e V OERALREGULATIONSPARTBTOFTITLE40ANG AQMO RULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMO ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMIT EXPfRED ��11 )�%i'�'LX PERMfT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED