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Home My WebLink AboutF2023-0120 - Permits�aeWPoRT City of Newport Beach Community Development Department - Building Division 0 �y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 c94roaN`P newportbeachca.gov/inspections Combination Type - SFP Work Class - New F 2 0 2 3 0 1 2 0II COMB Permit : F2023-0120 Plan Check No : PC2023-0375 Issued Date : 03/1312023 Inspection Area : 2 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 1015 DOLPHIN TER Legal Desc : N TR 5130 BILK LOT 4 Description: SFR FIRE SPRINKLER SYSTEM 10 HEADS (X2021-2303) Owner: PETER POLOS Address : 2 HERMITAGE LN NEWPORT BEACH, CA 92660 Phone: Applicant : MONTY CASEY Address : 1101 KINGSTON DR LA HABRA, CA 90631 Phone: (714)476-5370 Owner/Builder : Address : Phone Contractor: MONTY CASEY Address : 1101 KINGSTON DR LA HABRA, CA 90631 Phone: (714)476-5370 Con State Lie : 876004 Lie Expire : 04/30/2024 Bus Lie : BT30040107 Bus Lie Expire : 07/31/2023 Workers' Compensation Insurance Carrier: NATIONAL CASUALTY COMPANY Policy No : SWC1373758 W. C. Expire : 2/15/2024 Architect Address Phone: State Lie Engineer: ' Address Phone: " Designer: MONTY CASEY Address: 1101 KINGSTON DR LA HABRA, CA 90631 Phone: (714)476-5370 Code Edition : 2019 Fire Sprinklers : YES Construction Valuation : Type of Construction : V-B Fire Hazard Zone : NO Added/New/Ti sq. ft. Bldg Occupancy Groups : No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 2 Added/New sq. ft. Garage TOTAL sq. ft. Building Setbacks : Front: 6, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY SPECIAL CONDITIONS: $1,000.00�- ' 0 0� OWNER -BUILDER DECLARATION t 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 items) (Section 7031-5. Business end Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior toits 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:SecLon 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not 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 L) portions of the work, and the structure is notintended or offered for sale (Section 7044, Business 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 improvements 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 R was not built or improved 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 apply 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). ❑ 1 am exempt from hcensure under the Contractors' State License Law for the fallowing reason _ By my signature LE:cw 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 -all a structure thnr I 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 010rbssbns Coyle, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/ceiaw.html. Signature of PropEdy Owner or Authorized Agent _ Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of Division 3 of the Business and ProrHOUSANO Code, and my license is to full force and Effect. License Class License No Date 3 Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDREDOLLARS ($100,000). IN ADDITION TO THE CD^T of COMPLK SA -In N. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. I ' i,eby affirm under penalty of perjury one of the following declarations: L3 1 ;nave and will I.lalntam 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 IN t,yr`c mance 61 ;he cork for which this permit is issued. Policy No. have and -ill maintain workers' compensation insurance, as required by $action 3700 of the Labor Code, for the performance of the work for which this permit Is issued. My workers' r9nce carrier wnd policy number are: Policy Number Expiration Date of Agent certify that. in the performance of the work for which this permit is Issued: I shall notemploy any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agree t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant51� Date�fr_ CLARAT[GN REGA ING $TRflCTIGN LENDING AGENCY aOaby affirm under p ally of perjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, C Code). iders Name Lender's Address my signature below. I certify to each of the following: I am In, 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 coup ordinances and state laws relating to building construction. I authorize representatives of this city or county YvenIter the above -identified property for inspection purposes. Si nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name h • .. It to 7 L ACTION DATE BY D 'ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY % REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 PERMITEXPIRE- LJISUBMITTED ASBESTOS NOTIFICATION TO PERMOFCANCELLED_ EPA — PERMDEDIT FXTEN — _ QM D PERMIT FINAL CERTIFICATZOCCUPANCY OF /�/zq' � ASBE5T05 NOTIFICATION 15 NOT APPLICABLE TO PROPOSED DEMOLITION OCCUPANCY ISSUED / SIGNATURE: