HomeMy WebLinkAboutF2019-0079 - Permits�ywro4� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII II
�4 100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 1 9 0 0 7 9
F Permit Counter Phone (949)644-3288
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Job Address: 265 EVENING CANYON RD NB
Inspector Area: FIRE
Owner:
BJ 8 SONS LLC
Address:
18991 EDINGTON TER
IRVINE CA 92603
Phone:
Applicant:
DEMIITEALE MARK
Address:
2900 BRISTOL ST BLDG A203
COSTA MESA CA 92626
Phone:
949-975-0123
Code Edit : 2016
Type of Construction
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units: 0
Flood Zone:
Bldg Sprinklers: N
Description: SFR FUEL MODIFICATION
Legal Description: TRACT NO 1116 LOT 136 AND POR A13AND STIR (GLEN DRIVE)
Contractor: OWNER/BLDR Architect:
Address: GHAZNAVI BABAK Address:
Phone:
Con State Lie: OIB
Lie Expire:
Bus Lie:
Lie Exp Date:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Issued Date: 0510212019
Setback- Front:
Rear:
Left:
Right:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
FIRE Permit: F2019-0079
Project No: 2985-2018
Inspection Requests Phone (949)644-3255
:,cod ,M -
TEALE MARK �� ^
2900 BRISTOL ST BLDG A203
COSTA MESA CA 92626
949-975-0123 State Lie: CO22162"
BURKE LEO ....
^ ^
34167 PACIFIC COAST HWY #9n " n n
DANA POINT CA 92629 " ^
949-226-7130 State Lic: C-0%7464,
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FEES
Construction Valuation:
$500.00
Building PC Fee :
$0.00
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:
$136.00
Public Works PC Fee:
$0.00
$0.00
Fire Permit Fee :
$127.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee:
$0.00
TOTAL FEE :
$263.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$263.00
PROCESSED BY: OTHER DEPARTMENT:
ZONING APPROVAL: PLAN CHECKED BY::
FIRE APPROVAL: APPROVAL TO ISSUE:,
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
ER -BUILDER 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 L) 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
n�prroo Ed for the purpose of sale).
d" 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 grcoerty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly my siryiature below I acknowledge that, except for y personal ence in which I must have resided for at least one year prior to completion of the improvements covere by this permit, I cannot legall,
el; a structure th;.t I havc built as an owner -builder if' has tbe, ted i by licensed contra rstand that a copy of the applicable law, Section 44 of th�Business and
'rofessions Code, is available upon request when t a Ica ed lowi g.We info.ca.gov/calaw.html. L 11
ionatrw of Property Owner or Authorized Agent /DatICENSED CON TRACTOR'S DECLARATI
hereov afirm und.n penalty of perjury that I am Icensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionand my license is in full force
nd effect.
icense Class License No Date Contractor Signature
COMOENSATION DECLARATION
FAILURE TC SECUPE 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
:UMPENSA r,3,d, LA.AAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ha,aby affirm under penalty of perjury one of the following declarations:
have and will mn+ntain 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
)rmance 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 work for which this permit is issued. My workers' compensa
rance carrier and policy number are: -
ie of Agent
certify that, in the pi
, if I should become
Policy Number Expiration Date
Phone #
of the work for which this permit is issued, I shall not employ any person in any manner so as to become sL
hayvy rs nsej ign provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those
nature of Applicant / v C/
CLARATION REGA ING CONSTRUCTION LENDING AGENCY
areby affirm under nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
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 cou y ordinances and state laws relating to building construction.
I authorize representatives of this city or countyyI erlEet�� ed operty for i ec Io poses.
nature of Property Owner or Authorized ALtent l n pertv Owner's or Authorized Agent
ACTION
PERMITEXPIRED
PERMIT CANCELLED
PERMITEXTENDED
PERMIT FINAL
CERTIRCATEOF
OCCUPANCYISSUED
DATE /I BY
FEDERAL REGULATIONS PART61 O€TIiLE40AND
AQMO RULE 1403.
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS M017RCATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
to the workers' compensation laws of California, and
_L-1
(Section 3097, Civil Code).
FOR OFFICE