HomeMy WebLinkAboutF2023-0091 - PermitsCity of Newport Beach
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Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
644-3255
Inspection Requests Phone: (949)
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newportbeachca.gov/inspections
Combination Type - SFP
Work Class - New
II III II I IIII IIIIIIIIIII� IIIIIII ��I�I�IIIII II COMB Permit : F2023'UU91
Plan Check No : PC2023-0375
Issued Date : 02/16/2023
Inspection Area : 2
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAV OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 1015 DOLPHIN TER Legal Desc : N TR 5130 BLK LOT 4
Description: SFR FIRE SPRINKLER SYSTEM WITH 44 HEADS **X2021-2303**
Owner: PETER POLOS
Address : 2 HERMITAGE LN
NEWPORT BEACH, CA 92660
Phone
Applicant: MONTY CASEY
Address : 1101 KINGSTON DR
LA HABRA, CA 90631
Phone: (714)476-5370
Owner/Builder :
Address :
Phone
Contractor:
MONTY CASEY
Address :
1101 KINGSTON DR
LA HABRA, CA 90631
Phone:
(714)476-5370
Con State Lic
: 876004
Lic Expire :
04/30/2024
Bus Lic:
BT30040107
Bus Lic Expire : 07/31/2023
Workers' Compensation Insurance
Carrier: NATIONAL CASUALTY COMPANY
Policy No: SWC1373758
W. C. Expire: 2/15/2024
Architect
Address
Phone:
State Lic:
Engineer:
Address :
Phone
Designer: MONTY CASEY
Address: 1101 KINGSTON DR
LA HABRA, CA 90631
Phone: (714)476-5370
Code Edition :
2022
Fire Sprinklers :
YES
Construction Valuation :
$4,400.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg:
0
Occupancy Groups :
R3/U
No of Units :
1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories :
1
Added/New sq. ft. Garage:
0
TOTAL sq. ft. :
0
Building Setbacks :
Front: 6, Side: 4, Side: 4, Rear: 10
Flood Zone:
X
Use Zone :
R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS
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)
'Section 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
he permit to file a signed statement that he or she is licensed pu€suantto the provisions of the Contractors' State License 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
iot more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' ar personal effort, builds or improves the property, provided that the
mprovements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that It was not built or
'moneyed for the purpose of sate),
o
J 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).
J 1 am exempt from licensure under the Contractors' Slate License Law for the following reason:
3y 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
;all a structure that I have builtas on owner -builder if 4 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
>rofessions Code, is available upon request when this application issubmitted or at the following Website:http:],' w .leginfo.ca.govlcalaw.html.
'signature of Property Owner or Authorized Agent Dale
'_ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. License Class License No Date f 11 Contractor Signature
NORKERS' COMPENSATION DECLARATION
YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS f$1D0,0001, IN ADDITION TO THE
JOST 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:
-11 have and will maintain a certificate of consent to self -Insure for workers' compensation, issued by the Director of Industrial Relationsas provided for by Section 3700 of the Labor Code, for thf
rerformance 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 performance of the workfor which this permit is issued. My workers'
rance carrier and policy number are:
Policy Number Expiratic
of Agent Phone #
Date
certify that, in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
. if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith Comply with those provisions.
Date
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 (Section 3097, Civil Code).
.ender's Name Lender's Address
3y 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 Ihib dpplicalien and the information I have provided is correct.
I agree to col apl7 with all applicable city and county ordinances and state laws relating to building construction.
; Luthorize aprej-natives of this city or county to enter the above -identified property for inspection purposes.
3lgnature of PrcEarty Owner or Authorized Agent 4%1 _/ Pnnl Property Owner's or Authorized Aoent's Name M•..� i. r-,
€RM'T FINAL
CERPtICATE Of
Jut,,'ANCY ISSUED
DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40AND AQMD RULE
NOTIFICATION IS NOT APPLICABLE TO