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Home My WebLink AboutX2021-1839 - MiscHEATHER EUSEBIO Department Assistant heusebic@newporfbeachca.9ov 949-644-3290 CITY OF NEWPORT BEACH 100 Civic Center Drive, Newport Beach, California 92660 newportbeachca.gov - ,Xftt-14Su1 201 COCA, 1gVL NEWPORT BEACH LE VELOPMENT DEPARTMENT x, DO DI'VISaiyir O. Box 1768 1 Newport Beach, GA 92658-8915 www.newportbeachca.gov 1(949) 644-3200 ACKNOWLEDGMENT OF NO CONSTRUCTION -RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS On June 11, 2019, the City Council adopted an ordinance restricting construction -related noise on Saturday in High Density Areas effective August 12, 2019, I acknowledge that any construction -related noise, (including, but not liml:od to operating power equipment or machinery in a manner that produces noisy) is not allowed on Saturday or Sunday in High Density,Areas in accordance with Newport Beach Municipal Code 10.28,040. As the owner of the property, I am responsible to ensure all persons working on the prope ;y comply with this provision of the Newport Beach Municipal Code. Pr_ofect Address q2('� Owner's Name: Owner's Signatt Contractor's Signature: Date:____-- _ / / /•�� - -- I FamvAcknowledgment_HE Salurday_ConsUuallon HlghOensilyNeas CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newi)ortbeachGa.gov 1 (949) 644-3200 OWNER -BUILDER ACKNOWLEDGEMENT AND INFORMATION VERIFICATION (HSC 19825) NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submit the property improvements specified at We are providing you with an Owner -Builder Acki make you aware of your responsibilities and possible your name as the Owner -Builder. We will not issue a building permit until you h provision, signed, and returned this form to us a owner cannot execute this notice unless you, the permitting authority. in eR owledgment and Inrofmafion Vedfidation Form to rl� risk you may incur by having this permit issued in U�- ave read, initialed your understanding of each gZ(;ilQZ t our official address indicated. An agent of the property owner, obtain the prior approval of the OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION Read and initial each statement below to signify you understand or verify this infor.rct;on. 4 I understand a frequent practice of unlicensed persons is to have the property owner obtain an ner-Builder" building permit that erroneously implies that the property owner is providing h-s or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while worr.ing on my property. My homeowner's insurance may not provide coverage for those injuries. I am wilfully acti g as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to wo:l:ers on y property. I understand building permits are not required to be signed by property owners unless they are r nsible for the construction and are not hiring a licensed Contractor to assume this responsibility. . I understand as an "Owner -Builder" I am the responsible party of record on the permit. I 411 land that I may protect myself from potential financial risk by hiring a licensed Contractor and havin ` the permit filed in his or her name instead of my own. I understand Contractors are required by law to be licensed and bonded in California and to list qnse numbers on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed ors, and the total value of my construction is at least five hundred dollars ($500), including labor erials, I may be considered an "employer" understate and federal law. I I understand if I am considered an "employer' under state and federal law, I must register with the sta 3nd federal government, withhold payroll taxes, provide workers' compensation disability insurance, and ' ntribute to unemployment compensation for each "employee." I also understand my failure to abide b, th a laws may subject me to serious financial risk. _ I understand under California Contractors' State License Law, an Owner -Builder who builds e4&@ mily residential structures cannot legally build them with the intent to offer them for sale, unless all wo kVs performed by licensed subcontractors and the number of structures does not exceed four within�gny calendar year, or all of the work is performed under contract with a licensed general building I nderstand as an Owner -Builder if I sell the property for which this permit is issued, I may be held-' � for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. Forms\owner builder verifdm 08/12/16 1 of 2 l I understand I may obtain more information regarding my obligations as an "employer" from the Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.r-slb.ca.gov for morel information about licensed contractors. 0. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and stand that I am the arty legally and fippancially responsible for pro�ppo�sed construcn activity at the na address: PJ Lc1fn\ lJ� �1 Q� FPXIN� 0(1(' Yt r L h. I agree that, as the party legally and financiallfl responsible fdr this proposed construction y, I will abide by all applicable laws and requirements that govern Owner -Builders as well as 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to fthe information I have provided on this form. Lice0ed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the City of Newport Beach, Building Division, for issuing the permit. Note: A copy of the property owner's driver's license or form notarization is required to be presented when the permit is issued to verify the property owner's signatyre. Print name of property owner: Property Owner's Note: The following Authorization Form Ire_dd to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: Note: A copy of the owner's driver's license or form notarization is required to be presented when the permit is issued to verify the property owner's signature. Forms\owner builder verifdm 08/12/16 2 of 2 California DRIVER LICENSE IL D5594203 class cM1 E.!04/09/2026 END NONE _N MORALES EN FRANCISCO JAVIER 214 EMERALD AVE NE ORT BEACH, CA 92662 DoR 04/09M 974 RSTR NONE 04091974 SEX, M HAIR 21 EYES NRN 6' HGT -08" WGT V1721b .. I6S DO 04N912021620091CCM26 041091202'1 CITY OF NEWPORT BEACH -` (f COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive 1 P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newportbeachea.gov 1 (949) 644-3200 SMOKE DETECTOR AND CARBON MONOXIDE SELF -CERTIFICATION (this certification is to be filled out by the permittee or homeowner) Project Address: Permit Number: Property Owner: Licensed Contractor: b 1 Co��l ` �112 hies Zaak,,, r Z(�oZ Lic #: The State of California now requires that smoke and carbon monoxide detectors must be installed in all residential buildings California Residential Code (CRC) Section R314.1, CRC R315.2 states in part that existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors. CRC Section R314.3, CRC R315.3 defines required locations. Both boxes below must be checked. Carbon Monoxide Alarm: On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms or in each hallway outside of the rooms, and each level of the dwelling. Detectors are also required in bedrooms with gas fired appliances ail Smoke Alarms: Installed in each room used for sleeping purposes, outside each sleeping area, and on each level of the dwelling unit. Retrofitted detectors may be battery operated for buildings where no alterations are performed on the interior. Multiple -purpose alarms (carbon monoxide and smoke alarms) shall comply with all applicable standards and must be approved by the State Fire Marshall. The devices must be installed per manufacturer's specifications. 1, the undersigned, hereby certify that I am the permittee or homeowner of the project. I further certify that smoke alarms and carbon monoxide alarms are present and tested the following locations: Date: Zz— NOTE: This self -certification is only used for projects to the exterior of the structure where access to the interior of the dwelling by the City of Newport Beach Building Inspector is not achieved during the course of construction. Fofm§:9mokoDeWdorondCa(bo Momdde6elf0eft 08/12/16