HomeMy WebLinkAboutX2022-0113 - PermitsCity of Newport Beach - Building Division 'X2022-0113' COMB Permit: X2022-0113
�# d 100 Civic Center Drive, Newport Beach, CA 92660 � �'( PfOJeCt NO : 0128-2022
Permit Counter Phone (949)644-3288 po .� y�"M1 °
i3 Inspection Requests Phone (949)644-3255 0; e.m> 0 ' Issued Date : 0210412022
Combination Type - GRAD Inspection Area : 5
MPLETEDB
412025 OR PERMIT WILL
PERMIT
onstruEXPIRES
coon Hours.SAFTER Mondays Friday 7.00 a.mSUAN OR . t VALID6.30 p.m. and Saturday f om 8.00 a.mO o 6 00 p.m. NoOwork on Sundays or Holidays INVALID
Job Address: 444 MORNING CANYON RD NB
Description: MFR DRAINAGE PER CITY STANDARD AND REMOVE WATER FEATURE W/ PUMP. *STOP WORK"
Legal Desc.:
Contractor: OWN Architect: S
Owner: TRAM KIKI
Address: 444 MORNING CANYON RD _ Addr N KIKI 1.
CORONA DEL MAR, CA 92625.:.. , , _ _-� O/B FORM ATTACHED ►f app 1
Phone: 714-434-757 Phone: 0/0 refiur:d S to Lic: ,
Phone: 714-434-7575 0619 Or � 10
Applicant: GALVAN EPHRAIM ` ZZ ate Lic: O/B ❑ a�inea r: , • ,
�' Lic Expire: JEAddress:?
Address: 33722 CHULA VISTA a _ '
DANA POINT, CA 92629A11111B ic: to wYd�0 .
D State Lic:
Phone: 949 412 7281 Vim^$ ? • ;
o ati nsu a Designer: GALVAN EPHRAIM ?
Code Edit: ,2019 Address: 33722 CHULA VISTA AVE
arrier.
Type of Construction DANA POINT, CA 92629 a
Occupancy Group `�y�•:` Policy No: -
Added /New sq it Bldg -
Policy r Phone: 949-412-7281
Rt
Added /New sq ft Garage vow I .riling Se' R Special Conditions: 121-3082
No of Stories Z F Fr nt 1
No of Units
Bldg Height: 0 aLeft: /
r Right: I
Bldg Sprinklers: %)F
Flood Zone: x'.Use Zone: Parkin S aces: 0 v re
[FRecord
on Valuation:000.00 POrrC $tarte�ermit Fee: $229.0TPlanning De Departmentk Fee: $199.23 ition ,1\ $0.00 Plan check ee: $0.00re In0.00 n R vs a n. $0.00
Plan Ck: $0.00 Gr di�r F1 $0.00Fair Share : $0.00 Feeion Fee: $229.00 Gra i",cConsultam : $0.00 SJH Trans : eP A $0.00anagement : $6;00 Grading Permit Fee: $474.00 ousing Fee : $o-l{>Qt 0 00
mpliance: $D`00 Grading PC Fee: Publ' rk 'D ant ArIsP' $
0 Refund Deposit $0.00
CA Seismic Safety: $0.00 Note. ee : $0.00 U P/W P 5 Grading Bond: $0.00
Disabled Access: $6.00/S an Dist : $0.00
Hazardous Mat $O:DO $0.00
Building Green Fee : $1.00 t o Mach ° $0. oo 0 NMUSD Fee: $0.00 $0.00
umbing %: $o
TOTAL FEE : $1,541.48 Plan Check Fee: $251.00 Fee Due at Permit Issuance : $1,290,48
Alf
6� PUBLIC WORKS APPROVAL: l f
PROCESSED BY: y
PLAN CHECK BY: `
ZONING APPROVAL:
APPROVAL TO ISSUE:
GRADING APPROVAL:
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 Business and Professions Code: The Contractors' State License Law does not apply to an owner (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, improvements are not intended or offered for sale. If, however, the building or improvement is solof property who, through employees' or personal effort, builds or improves the property, provided that the
d within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
Iim� roved for the purpose of sale).
C9 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).
❑ I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature tDlo v 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 legal]
sell a structure rhpt i have built as an owner -builder if it has not been co t ucted 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 applica n is ted or t the following Web site:http://Www.leginfo.ca.gov/calaw.htmi.
3ignatu:e of Properly Owner or Authorized Agent Date %� �T d�/ 2 a
LICENSED CONTRACTOR'S DECLARATION -•- _ - _.;..5.
herehy affirm under penalty of perjury that I am licensed un r provisions a(ley9 If�ncing with Section 7000) of Division 3 of the Business and Professions Code, and y license is in full force
and effect. License ;lass License No VW� Date Ir
NURKERS' CUM PENSATION DECLARATION - '--------- _ �� a �, IQnature _
��^.r'IPG: FAILURE TOSECUREWORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND n¢��l_8�{1If�n P TO OJ U Dd&yErp���H/_pUSAN DOL,�.,JgRE
DST OF COMPENSA-ICV, DAMAGES AS PROVIDED F04 IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LJ Z51.j "�0 Cr l�l '� a V /U rGj�U I iG hereby affirm under penalty of perjury one of the following declarations: G
} I have and. will, mpintain a certificate of consent to self insure for workers' compensation,issued by the Director of IndustliB61 VI D�S,,as provided for by Section 3700
erformance of fill work for which this permit is issued. Policy No. - - .-:�;�T tJ V'v R f UI t I. _
h; ve and dill maintain workers' cor
rance carrier and policy number are:
me of Agent
I certify that, in the performance of the we
d, if I should become subject tq11he worke
[nature of Applicant
CLARATION REGARDING C NS UC-
=reby affirm under penalty of erjury that t
ider's Name
my signature below, I certify to each of th
I am the property owner or authorized to
I have read this application and the infor
I agree to comply with all applicable city
I authorize representatives of this city or
nature of Property Owner or Authorized A
TION DATE
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
insurance, � as required by Section 3700 of the Labor Code for the performance of the work for which this permit is issued.
_ Poggy�nlumber- Expiration Date
ermit is issued, I shall not employ an y `._;;,v 1 p y y person in an In so as to become subject to the workers'
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lowing: �N prf�a sprlei�
on the property o�yners DDDehalt.
on I have provided is correct.
1403
OF
of the
state laws relating to building construction.
TO
N � e 'Fv,. � :A
'this permit"is Issued (Section
X
00,000), IN ADDITION TO THE
the Labor Code, for
workers' compensa'
ofCalifomia, and