HomeMy WebLinkAboutX2018-3103 - Permitsrxxt'c4 City of Newport Beach - Buildirlq_UbdAig
100 Civic Center Drive, Newport Beach, CA 926f0
Permit Counter Phone (949)644-3288 s
Inspection Requests Phone (949)644-3255 Date.
Combination Type - MFP PLUM j
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Project No :
If applicable:
Issued Date : 10/12/2018
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103
PERMl4"S E
Construction Hours: Monday -Friday t.00
pA04l rda `' r;n & O a.m. fo 6:00 p.m.
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Job Address: 507 MORNING CANYON RD NB
Description: MFR PEX REPIPE
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Legal Desc.: TR 12079 LOT 1 UNIT 11 OF PROJECT LOCATED ON Ae.
TOGETHER'. `7k a IF111111% IN _ __
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Owner: LLAURADO MIREYA
ContractNUNEZ AMPELIO-- Arcmrem .-
:.
Address: 507 MORNING CANYON RD
Address i'
00 E IMPERIAL H S!3 Address. ia7
CORONA DEL MAR, CA 92625
`
BREA CA 92821
Phone:
Phone:
714-618-2633 Phone:
State Lic:
Applicant: NUNEZ AMPELIO
Address: 2500 E IMPERIAL HWY #213
Con S 852741 Engineer:
Lic Expi 01/31/Xft--v "'' '- ' "
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I,, 6
BREA CA 92821
Bus Lic:.`
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Phone: 714-618-2633
Lic Exp ate:
04/3 /2019 Phone:
at Lic:
„.>+
Code Edit: 2016
Workers tom ensation
p
work started)
Ins rance Designer:
(no work started)
Type of Construction: V-B
Carrier.
TRUCK INSURANCE Address:
' ' -• '
Occupancy Group: R2
Policy.`-op-ito' A09473266
Added /New sq.ft. Bldg: 0
Expire:
` one.
- - -
Added /New sq. ft. Garage: 0
Insp. initialss'✓-_
No of Stories: 2
Building Sethnnkg
A9a': Spas a'Gerel;tianw
No of Units
-
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone:
Parking Spaces: 0 Fire Hazard Zone
: N
Construction Valuation: $2,500.00
Building Permit Fee: $120.00
Excise Tax:
$0.00 Planning Department -
Fire Department
Plan Check Fee: $0.00
Additional Fee :
$0.00 Plan check Fee : $0.00
Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00 Fair Share : $0.00
Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant :
$0.00 SJH Trans : $0.00
Demolition Fee
Record Management: $0.00
Grading Permit Fee:
$0.00 In -lieu Housing Fee : $0.00
Building Dept Adm
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00 Public Works Department -
General Service
$0.00
CA Seismic Safety: $0.00
WO Insp. Fee:
$0.00 Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access : $0.00
PAN Plan Check : $0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical W
$0.00 San Dist: $0.00
Building Green Fee : $1.00
Mechanical %:
$0.00 NMUSD Fee: $0.00
$0.00
Plumbing %:
$10.80
$0.00
TOTAL FEE : $131.80
Plan Check Fee: $0.00 Fee Due at
Permit Issuance :
$131.80
PROCESSED BY:�
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:,^y^\
GRADING APPROVAL:
APPROVAL TO ISSUE:
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, prior to 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 U 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
ap ly to an owney 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 licensure under the Contractors' State License Law for the following reason:
;3y ,ny Signature vc;low 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
sell a structure tha' ' ``ave 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
Ptcress'ons Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signdidre of Property Owner or Authorized Agent ate
L(CEASED C NTFACTOR'S DECLARATION
herJLy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7094 of Division 3 of the Business and a full force
1^c' ^ffect. License Class License No Date Contractor Signature
'A'CR:(ERS' COMPENSATION DECLARATION a
'.!.' 0. 1_C. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUN RED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
'.AST OF COMPENSi TION, JAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby, affirm under penalty of perjury one of the following declarations:
t'3ve and- I-" 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 the
VI
rmanceofhe wrk for which this permit is issued. PolicyNo.
ave 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' compensatiol
ce carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
I certify that, in the perfo ante of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' mpensation laws of California, and agre
that, if I should beco7enaltyof
rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
Signature of ApplicaD —
DECLARATION RESTRUCTION LENDING AGEN
I hereby affirm undeury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 30 7, Civil Code).
Lender's Name Lender's Address
By my signature be w, 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 hav 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 ropert ction purposes. /v U ate
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name,/,4�2
ACTION DATE BY 7 1 DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY _
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
PERMIT EXPIRED
ASBESTOS NOTIFICATION
PERMIT CANCELLED LJEPA
PERMIT EMENDED J QM D
PERMIT FINAL `���.'t,O ASBESTO�OTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF PROPOSE MOLITI
OCCUPANCY ISSUED SIGN