HomeMy WebLinkAboutF2022-0216 - Permitss �wt^ca City of Newport Beach - Building Division *F2022-0216*
5 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288 _
ra R T77
IN F+
Job Address: 630 VIA LIDO NORD NB
Inspector Area: 2
Owner:
KRUSE DANIEL
Address:
630 VIA LIDO NORD
NEWPORT BEACH, CA 92663
Phone:
Applicant:
MARTINEZ ROBERT
Address:
122 W POMONA WAY
MONROVIA CA 91016
Phone:
626-357-4045
Cade Edit : 2019
Type of Construction:
V-B-SPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
2
No of Units :
0
Flood Zone:
AE
Bldg Sprinklers:
Y
Description: SFR SPRINKLERS (29) HEADS (X2021-2850)
Legal Description:
N TR 907 LOT 61
Contractor:
CRAIG FIRE PREVENTION INC
Architect:
Address:
123 E CENTRAL AVE
Address:
MONROVIA CA 91016
Phone:
626-357-4045
Phone:
Con State Lic:
1037827
Engineer:
Lic Expire:
04/3012024
Address:
Bus Lic:
BT30048335
Lic Exp Date:
0813012022
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
AMERICAN FAMILY HOME
Address:
Policy No:
2EA5WC900091800
Expire:
02/11/2023
Phone:
Issued Date: 0
5106/2022
Special Conditions:
Setback- Front:
Rear:
Left:
Right:
FIRE Permit: F2022-0216
Project No : 1064-2022
Inspection Requests Phone (949)644-3255
State Lid:
State Lic
MARTINEZ ROBERT
122 E POMONA AVE
MONROVIA CA 91016
626-357-4045
FEES
Construction Valuation:
$6,900.00
Building PC Fee :
$222.00
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:
$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 :
$493.00
Plan Check Fee :
$222.00 Fee Due at Permit Issuance :
$271.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
JWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indic
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demc
.he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Li
Orofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sectic
iot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of th
3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through ei
improvements are nor intended or offered for sale. If, however, the building or improvement is sold within one year of compl,
improved for the pdipose of sale).
J f, ds owner or ¢he property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, E
apply to an owner o ' property who builds or improves thereon, and who contracts for the projects with a licensed Contractor I
r
I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature �Jiw I acknowledge that, except for my personal residence in which I must have resided for at least one yr
^ell a structure Atha" have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I unc
Professions Code, iP available upon request when this application is submitted or at the following Web site:http://www.leginf(
3.g,iuture of Property Gwner or Authorized Agent
'—:CCt1SED CONTRACTOR'S DECLARATION
I FE-cty affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of
and effe,t. ie s/4il'z, Z
License Class License No Date
ad below by the checkmark(s) I have placed next to the applicable item(s)
h, or repair any structure, prior to its issuance, also requires the applicant for
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
work, and the structure is not intended or offered for sale (Section 7044,
oloyees' or personal effort, builds or improves the property, provided that the
on, the Owner -Builder will have the burden of proving that it was not built or
siness and Professions Code: The Contractors' State License Law does not
rsuant to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
In 3 of the Business and Profe,$sions Code, and my license is in full force
Contractor Signature
✓OPKERS' COMCENSATION DECLARATION
NARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$10%0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
erformance 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 pei
insurance carrier and policy number are:
Policy Number
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
ie of Agent I rnone F.
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner s as to become subject to the workers' compensation laws of California, and
if I should become subjec(\to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith omply with those provisions.
nature of Applicant l� WU"
CLARATION REGARDIN ONSTRUCTION LENDING AGENCY
Ireby 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 state laws relating to building construction.
I authorize representatives of this city or county to enliprthe above -identified property for inspection purposes.
nature of Property Owner or Authorized Agent Print Property Owner's or Aut
permit is issued (Section 3097, Civil Cade).
r:S D te`51 2
ACTION
➢ATE
BY
DECLARATION OF COMPLIANCE MTNCODE
OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE
AQMD RULE 1403-
❑ 1 SUBMITTED ASBESTOS NOTIFICTN
[IEPA
❑ AOMD
40 AND
TO:
PERMIT EICPi'RED
PERMIT CANCELLED
PERMIT EXTENDED
El ASBESTOS N07IRCA7I0N /S NOTLICABLE
PROPOSED OEMOUTION.
SIGNATURE
TO
PERMIT FINAL
/
CERAFICATEOF
OCCUPANCYISSUE