HomeMy WebLinkAboutF2021-0101 - Permitsa City of Newport Beach - Building Division II�IIIIIII�IIIIIIII�IIIIIIIIIIIIIIIII�IIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 25 VIA DIAMANTE NB -
Inspector Area: 6
Owner:
LEDUC MINH
Address:
25 VIA DIAMANTE
NEWPORT COAST, CA 92657
Phone:
Applicant:
MARTINEZARMANDO
Address:
888 N H ST
SAN BERNARDINO CA 92410
Phone:
Code Edit: 2019
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units
Flood Zone:
Bldg Sprinklers:
V-BSPR
R3/U
0
0
FIRE Permit: F2021-0101
Project No : 0565-2021
Inspection Requests Phone (949)644-3255
Description: SFR ADD 1 FIRE SPRINKLER (X2020-2044)
Legal Description: N TR 15079 LOT 56
Contractor:
MARTINEZ FIRE PROT SYS
Address:
888 N. H ST
SAN BERNARDINO, CA 92410
Phone:
909-562-8637
Con State Lie:
955955
Lie Expire:
12/31/2022
Bus Lie:
BT30073741
Lie Exp Date:
12131/2021
Worker's Compensation Insurance
Carrier:
SECURITY NATIONAL INS
Policy No:
SWC1310641
Expire:
11/08/2021
2 Issued Date: 03/15/2021
0 Setback- Front:
X Rear:
Y Left:
Right:
Architect
Address:
Phone: State Lie
Engineer:
Address:
Phone:
State Lie:
Designer:
MARTINEZARMANDO
Address:
888 N H ST
SAN BERNARDINO CA 92410
Phone:
Special Conditions:
[omen
FEES
-IN
Construction Valuation:
$600.00
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
Building Investigation Fee:
$0.00
$0.00
Fire Plan Check Fee:
$160.00
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee:
$228.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTAL FEE :
$390.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance:
$390.00
PROCESSED BY: ...
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ZONING APPROVAL.,
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FIRE APPROVAL :
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
o > P PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
��e as,+ m e sa seG •en
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
the permit to file a signed 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
not more than five hundred dollars ($500). 1
LJ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through am
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of complet
improved for the purpose of sale).
❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, BL
apply to an owner of property who builds or improves thereon, and who contracts for the projects With a licensed Contractor pL
LJ I 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 yea
sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I unde
Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://w .leginfo.
Signature of Property Owner or Authorized Agent
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 0
and effect.
License Class License No Date r�e /
COMPENSATION DECLARATION
k, and the structure is not intended or offered for sale (Section 7044,
ees' or personal effort, builds or improves the property, provided that the
the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
that a copy of the applicable law, Section 7044 of the Business and
Date
,ision 3 of the Business and P f ssio tC;de dense is in fuI or
_ Contractor Signatur
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
051- OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNErS FEES.
hereby affirm under penalty of perjury one of the following declarations:
"ave and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Intlustrial Relations as provided for by Section 3700 of the Labor Code, for th,
ance of the work for which this permit is issued. Policy No.
3l he a and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfo ance of the work for which this permit is issued. My workers' compensatiol
Isuran a c,prr* and policy number are:
Policy Number
certify that, in the performance of the work for w ' this perm Is issued, I sha mploy any person in any manner so
if I should become subject to theq worlIers' co sation pro isions of Section 3 0 Labor Code, I shall forthwith c
nature of Applicant ! i'—+� t�z�
CLARATION REGAR I CON UCTION LENDING AGENCY
:reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which
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 st a laws relating to building construction.
I authorize representatives of this city or county to ent"e above-' ntified prof inspection purposes.
r �
Date
to become subject to the workers' Compensation laws of California, and
)ly with those provisions.
permit is issued (Section 3097, Civil Code).
/Al �I- Date
ACRON
DATE
BY
DECLARATION OF COMPLIANCE tMTH CODE OF
FOROTRCEUSEOyLY
FEDERAL RE GULA TIONS PART 61 OF TITLE 40 AND
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PERMIT CANCELLED
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