HomeMy WebLinkAboutF2020-0086 - Permitsr,N,okT City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 F 2 0 2 0 0 0 8 6
F Permit Counter Phone (949)644-3288
Job Address: 17 DARTMOUTH NB
Inspector Area: 4
Owner:
BENEHMED DANEIA SANADIKI
Address:
17 DARTMOUTH
NEWPORT BEACH, CA 92660
Phone:
Applicant:
MACBETH DANIEL
Address:
37 PARKCREST
NEWPORT BEACH, CA 92657
Phone:
949-584-4999
Code Edit : 2016
Type of Construction:
V-B
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:
Bldg Sprinklers:
N
FIRE Permit: F2020-0086
Project No : 2524-2019
Inspection Requests Phone (949)644-3255
Description: SFR FUEL MOD (X2019-3672)
Legal Description: N TR 15409 LOT 57
I t aV[ S P E^Ai.J' -reN
Contractor: MAC BETH DANIEL GARRISON
Architect:
R
Address: 1539 MONROVIA #11
Address:
NEWPORT BEACH CA 92663
Phone: 949-584-4999
Phone:
State Lic: " . , ,
Con State Lic: 700795
Engineer:
Lic Expire: 12131/2020
Address:
Bus Lic: BT30047260
Lic Exp Date: 06/31/2020
Phone:
State Lic:
Worker's Compensation Insurance
Designer:
Carrier: WC EXEMPT
Address:
Policy No: (NO EMPLOYEES)
-
Expire:
Phone:
Issued Date: 02/24/2020 Special Conditions:
Setback- Front:
Rear:
Left:
Right:
FEES
Construction Valuation:
$6,000.00
Building PC Fee :
$202.00
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 :
$240.00
TOTAL FEE:
$442.00
Plan Check Fee:
$0.00 Fee Due at Permit Issuance :
$442.00
PROCESSED BY:
ZONING APPROVAL: t
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE: L�V
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -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, priorto 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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended 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 it 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 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 year prior to completion of the improvements covered by this permit, I cannot legallt
sell a structure that I nave 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
S;gau;u:L of Property Owner or Authorized Agent Date
LICENSED CO!'71RASTOR'S DECLARATION
I herby nffinn under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the Busine/NEHUNDRED
Pr ions ode, and my license is in full force
and etfect.
License Class _ _ _ �� License No ! CJdDate —{� �� Contractor SignaA
WORKERS' COMPENSATION DECLARATION
NAHNING: FAILURE TO ScCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPL YER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE
C')rT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hrmh,•�.f irm under penalty of perjury one of the following declarations:
I have and will mailtain 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
cr.r.a.)ce of the work for which this permit is issued. Policy No.
nave 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
ranee carrier and policy number are:
of Agent
ertify that, in the perform ncl
if I should become subjqbt to
lure of Applicant _
Policy Number
Date
For which this permit is issued, I shall not employ any person in any manner so as to become subject t the workers' compensation laws of California, and
roviyo compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pns.
CLARATION REGARWNG CONSTRUCTION LENDING AGENCY
areby affirm under pe lty 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 owners behalf.
I have read this application and the information I have rovi I correct.
I agree to comply with all applicable city and county nces a d state laws relating to building construction.
I authorize representatives of this city or county to e t -identified property for inspection purposes.
nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent
</— 2 v
(Section 3097, Civil Code).
Name
C7p eelse,z %vl✓3cl��L.
INA
ACTION
DATE
BY
DECLARATION OF COMPLIANCE V✓ITHCODEOF
FOROFRCEUSEONLY
FEDERAL REGULATIONS PART fit OF TITLE40AND
AQMD RULE 1403.
PERMITEXP)RED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
ASBESTOS NOTIFICA
PROPOSED DEMOLITION.RONIS NOT APPLICABLE TO
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PERMITFINAL
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CERTIRCATEOF
SIGNATURE:
OCCUPANCYISSUED