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HomeMy WebLinkAboutX2016-2196 - PermitsBaa City of Newport Beach - BtAding Division �an check Fee : $0.00 Fire Inspection: 100 Civic Center Drive, Newport Beach, CA 92660 N ^;, Permit Counter Phone (949)644-3288 ,.; Inspection Requests Phone (949)644-3255 r Combination Type - SFP MECH ELEC PLUM PERMITS INSTALL OR VERIFY SII91 Job Address: 4 CANYON FAIRWAY DR NB Description: *"CHANGE OF CONTRACTOR""" -'8022) SFR Legal Desc.: N TR 10814 LOT 15 .1 - Owner: r_ Owner: Address: Phone: Applicant: Address: Phone: 9491 Code Edit : Type of Constructii Occupancy Group: Added /New sq.ft. I Added /New sq. k. No of Stories: No of Units : Bldg Height: Bldg Sprinklers: Flood Zone: Building Permit Fee: Plan Check Fee: Overtime Plan Ck: Investigation Fee: Record Management: Energy Compliance: CA Seismic Safety: Disabled Access: Hazardous Mat Building Green Fee FAIRWAY DR $0.00 IIIIIIII�VIII0 VIII AI I IILIIIIID9 III II COMB Permit: X2016-2196 Project No: 0009-20% meoo e o Issued Date: 07105/20160". eo Inspection Area : 4 • e •° . c .. m 9i180 -DAYS AFTER I t9CE-OR LAST V ID��JJ PECTION-r, m - - - - m ARBON MON0X(9T CTORSfP�LI/��FhCTURES TO E UPGRADED nnr` RED PATI,VVO-( 4t�fr4/C0& VERT GARARGE TO,J,1,V-Ff SF REMODEL 3,190 ANSPE • •11 LTD �Z,;.i°' Contrk fi 'WESRN PAq1PGREW Architect: BAILEY VID o • • • o o o• o ®• m o � •" Odd# V R BLVD #102 Address: 23187 LA I i0 "% ,a1 - 2612 LAGUNA H I 4.iPto to78.8937 Phone: 949-573-10 0a StateLic 88 443 Engineer: HAKIM FADI Lic Expir__e,/ %20 D Address: 7545 IRVINE I Bus??��cv"Y"' ��. T VAI IRVI CA 92 Phone:OMPR-1536 C� atioh Insurance e ignr,J' Carrie TRUCK INS EXC6E 7"°� r� es . �. Policy No: A094710 Expire: 04/21/ 017 �NI ` �^ I o6ee.) 4 Buildin S%Rear: / % � 0 Special Conditi" LLANDSI-44 Front: /o HA 2`S1 Lek: / a��16- . 'z r �1 Right: / %'• .UssZDDA) Parkina Spaces: ®'it re Hazard�8'Re : N TOTAL FEE: $32.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excl Tax: Y,'W'� $0.00 g Bonds Fee: 0. 4 Grading PC C ant : 00 Grad' ermit Sa. $0.00 radi K'ee: $0.00 'WaInsp. Fee : $0.00 Electrical %: $0.00 Mechanical %: $0.00 Plumbing %: $0.00 Plan Check Fee: VA DR#101 aeommo CA 92653 om•Boom °ee•om State Lic:CO27404 °O m DR #200 State Lic:C-075736 Plangjppartment - Fire Department �an check Fee : $0.00 Fire Inspection: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 SJH Trans : $0.00 Demolition Fee In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Public Works Department - General Service $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check : $0.00 Grading Bond: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $32.00 PUBLIC WORKS APPROVAL: II// C" PLAN CHECK BY: APPROVAL TO ISSUE:9-I�YI I hereby affirtrsunder 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) (taOfiDBd031.5, 13usirms 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 tfle perrMt to file aSigned statement that he or she is licensed pursuant to 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 rot more than five hundred dollars ($500). .. Q I, Be owner of the eloperty, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Efus66s and Proiesslons Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the iplpGoyrments a:e Qotlrytended 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 Tjr;oygd for the -purpose of sale). „asowner of tAe property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not 6 ply to en owns - ofp.rvperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). j pql exempt from IiCensure under the Contractors' State License Law for the following reason: By. �% signature "" 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 legall•, sella structure that I.have built as an owner -builder if it has not been sepstructed in its ent' licensed tractors. I understand that a copy of the applicable law, Section 7044 of he Eisiness and Professions Code, is available upon request wheel this applicabmitted or at the I e:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized AgeI , 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 Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION IARNING: 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 ($100,000), IN ADDITION TO THE :OST 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: 7 I 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 e;Lormance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number 1e of Agent certify that, in the performance of the work if I should become subject to the wor as lature of ApplicanV- Date I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree ction 3700 of the Labor Code, I shall forthwith comply with those provisions. j( -^�t I Date Y t S� ( Ireby 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) 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 ggq4tateplating to building construction. I authorize representatives of this city or cougty to enter-identif ro for inspection purposes. I, A 1 _ _ n ,,,, 1_91 . PERMIT EXTENED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED Owner's or Authorized Au BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AN D AOMD RULE 1403 LJ I SUBMITTED ASBESTOS NOTIFICATION TO NOTIFICATION IS NOT APPLICADW, TO � y v� v a � C tU0 L O N 12 U = L u O C U Q m O i C LU U ry u N LU a ° M > +L+ O O N a a C > N C Psi v a 6 h�9 p o �9 > - ❑ � [0 vOi V1 W4 O a v =' o u a Z c �' a o u +L• E 2 w o 814 a v = c O u ^� c 3 l� L OLO L C @ U N Q/ N S +' Bm9 N fO ❑ U N qqp� N L„ U L y L <U N C U O i n' '^ a N N i X T d U VI O Ov In Ll C N NO N u G ❑ V @ O L O H T a 0 0- 3 O a Q a S N � Q� m O N 00 N U Q Ql O O N> > O 61 N m a H 3 2 a` ti 0 M a m a