HomeMy WebLinkAboutF2021-0460 - PermitsgN rrx City of Newport Beach - Building Division 111p111111111p11111p11111111111p1111111111111p1 P FIRE Permit: F2021-0460
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 1 -0 4,�s-41, Project No: 2306-2021
Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
Job Address: 10 RIVAGE NB
Description: FUEL MODIFICATION
Inspector Area: 6
Legal Description:
N TR 15333 LOT 39
-
Owner: KLINE JOHN
Contractor:
BRYCE SANTANIELLO
Architect:
Address: 10 RIVAGE
Address:
3419 VIA LIDO UNIT 115
Address:
"
NEWPORT COAST, CA 92657
NEWPORT BEACH CA 92663
.... -- _
Phone:
Phone:
714.600.3719
Phone:
State Lic:
Applicant: SNTANIELLO JAMES
Con State Lic:
1070607
Engineer:
HUSZCZ MARIAN JOHN - -
Address: 3419 VIA LIDO
Lic Expire:
11130/2022
Address:
8 CORNWALLIS - -
NEWPORT BEACH CA 92663
Bus Lic:
BT30078093
IRVINE CA 92620
Phone: 714-815-5097
Lic Exp Date:
02128/2023
Phone:
W-551-3316 State Lic: S-00:,555
Code Edit: 2019
Worker's Compensation Insurance
Designer:
_
Type of Construction:
Carrier:
EXEMPT
Address:
Occupancy Group: U
Policy No:
NO EMPLOYEES
Added /New sq.ft. Bldg: 0
Expire:
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 0
Issued Date: 04/25/2022 Special
Conditions:
No of Units : 0
Setback- Front:
Flood Zone:
Rear:
Bldg Sprinklers: N
Left:
Right:
FEES
Construction Valuation:
$100.00
Building PC Fee :
$222.00
Fire Residential Alarm PC Fee :
$0.00 Records Management:
$0.00
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:
$0.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$269.00
TOTAL FEE :
$491.00
Plan Check Fee:
$222.00 Fee Due at Permit Issuance :
$269.00
PROCESSED BY: Cb',
ZONING APPROVAL: ►✓`-'-D�.l
FIRE APPROVAL: ,
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
ILDER DECLARATION
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
ie 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
'rofessions 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
of 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness and Professions 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
nprovements 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
nproved for the purpose of sale).
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
pply 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).
I am exempt from Iicensure under the Contractors' State License Law for the following reason:
y 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
ell a structure that' have built as an owner -builder if it 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 is submitted or at the following Web site:http:/Aw .leginfo.ca.gov/calaw.html.
igoatu,e of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
herby affirm ur,car penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of Division 3 of the Business an Professions CO E /and my license is in full force
nd eftect. _ /
icense Class License No Date Contractor Signatur
VORKERS' COMPENSATION DECLARATION
ARNING- FAILURE TO SE:'IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO HUN DR OUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF �OMPENLATIOA, LAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
h3-cby affirm under penalty of perjury one of the following declarations:
nave and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
Trance of the work forwhich this permit is issued. Policy No.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
urance carrier and policy number are:
of Agent
rtify that, in the performance of
I should become subjecl to the
Policy Number
Date
for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
compe_Wtion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provysions. / /
mature of Applican 4.$�./ — DateA S L5 i—
CLARATION Rgg NSTRUCTION LENDING AGENCY
3reby affirm under 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:
1 am the property owner or authorized to act on the property owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinanc 70and state le relating to building construction.
I authorize representatives of this city or counVto epterjh bove-ii I "" " property for inspection purposes.
of Property Owner or Authorized
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTEDASBESTOS NO77FICATtON TO:
❑ EPA
❑ AQMD'
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NODFICARON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
2p Q S
CERTIFfCATEOF
SIGNATURE.,
OCCUPANCYISSU€D