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Home My WebLink AboutX2019-0513 - Permits70 a City of Newport Beach -Building Division If (�II I�I COMB Permi# : X2019-0513 � � . "i0i3 Civic Renter l:3rive;,Ne�rpprt beach, CA 9266(l Permit Counter Phone'(949)644-3288 2 0 1 9 g5 1 3 X: , Project No : I ,$ s Inspection Requests Phone (949)644-3255 Issued Date: 02/1912019 Combination TYp e - MFP PLUM Inspection Area: 5 G o ° PERMITS EXPIRE 1s80 I.BA`3'S AFTERISSUANCE C OR LAST VALID /I S 7ii3t�'. a . c C c r e c >� on Hours: onday - Fn ay 7. a. _ to 6.-30 .m. and Saturday from 8:Oit ,m. to 6. €9 .r _ o work err# Sundays or Holidays 00000 . �ob�Ad&ess 51`3 MORNING CANYON RD NB" - 196ecaption:; MFR - PEX RE -PIPE Ledl Gersc_: TRo1+"Jr�- 79 LOT 1 UNIT 14 OF PROJECT LOCATED ON AP 459-151-26 TOGETHER 0 4Nne o YACENDA JAMES E Contractor. NUNEZ AMPELIO Architect: o. A8gress: 513 tl`If.00NING CANYON RD Address: 2500 E IMPERIAL HWY #213 ` Address: "CORONA DEL MAR, CA 92625 BREA CA 92821 Pam_ Phone: 714 618-2633 Phone: Slate Lic: o� o A li n • NUNEZ AYePEL1O Con State Lic: 852741 `$- Engineer: o , *FERIAL HWY #213 Lic ire. Addre ss_- 2500 vo �p 2 21 01/31/ 0 Address: 0 .: B �c92821 - - - Bus Lic. Phone: 714618-2633 Lic Exp Date: BT30062723 04/30/2019 ... .. _. Phone: State Lic: Insurance Designer = Code Edit:, 2016 Workers Compensation r. Type of Construction: V-13 Carrier. TRUCK INSURANCE Address: a N ,� :3 '� `Wa9' . Occupancy Group: R3 . Policy No: A09473256 Added /New sq.ft. Bldg:' 0 Expire: 08/01/2019 Phone; Added /New sq. fL Garage: 0 No of Stories: 3 = Building Setbacks Rear : J Special Conditions: No of Units : 1 Front: / BldgHeight: 0 ' Left: J Bldg Sprinklers: Right: / I Flood Zone: Use Zone: ParkingSpaces- 0 Fire Hazard Zone: N Construction Valuation: $3,500.00 Building Permit Fee: $136.00, Excise Tax; $0.00 Planning Department- Fire Department $0,00 ' Plan Check Fee: $0.00 Additional Fee: $0.00 Plan check Fee: $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 ' : Gradirig Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev, Investigation Fee: '` $0.00 Grading PG Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Adm $0.00 Record Management: $0.00 Grading Permit Fee: $0.00 ' In -lieu Housing Fee :' $0.00 Building Dept , $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 ' Public Works Department- - General Service . $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee : '. $0.00 Park Dedication : $0.00 ` PM1 Plan Check : $0.00' Refund Deposit Grading Bond: $0.00 Disabled Access ,' $0.00 W Hazardous Mat $0.00 Electrical $0.00 San Dist : $0.00 $0.00 Building Green Fee : $1.00 . ' Mechanical %: $0.00, NMUSD Fee: $0.00 $0.00 Plumbing %: $12.24 . TOTAL FEE": $149.24 " Plan Check Fee:. $0 00 Fee Due at Permit issuance ; $149.24 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: i 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, Businessland 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). ❑ 1, as owner of the property; or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (erect on37044, 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 gin improvements are nat 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 thatoibulpa of built or I improved for the purpose Of sale). ❑ 1, as owner of the roe � o p p rty, 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). Sur P P J P ) Pp Y p P Y ❑ I am exempt from licen a under the Contractors' State License Law for the following reason: By; my signature belowil 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 thie l grmit 1 cannntleoall- sell a structure that 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 ,he *LsineSS an6 Professions Code; is'availa,ble'upon request when this application is submitted or at the following Web site:http:l/www.leginfo.ca.govlcalaw.htm1. Signature of Property bwn'6r or Authorized Agent Date LICENSED CONTRACVOR'S DECLARATION I hereby affirm underlpenalty, of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7 ) df [Div�isl!.o,rf 3 of the Business and Professions Code, and m et license in fi i ic��e and effect. License d, License No % —I ntractor Signatur WORKERS' COMPENSATION DECLARATION \ ARNING: FAILURE TO SECUREWORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. _ - - 1 hereby affirm under penally of perjury one of the following declarations: R have and will maintaln 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 thmance of the work for which this permit is issued. Policy No. ve 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' compensationce carrier and) policy number are: Jae r 1 Policy Number Expiration Date Name of Agent Phone # ❑I certify that, in the performance 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' compensation laws of California, and agre that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant D 2h t 9 � � 0 DECLARATION REGIdG CONSTRUCTION LENDING AGENCY_ k I hereby affirm under;pena6 of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders Name Lender's Address By'my signature below,) 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 have provided is correct: agree to comply Ni4hlall applicable city and county ordinances, and state laws relating to building construction. authorize representatives of this city or coun ntfed rope�fors ection purposes. r+_ Signature of Property Owner or Authorized Agen Property Owner's or Authorized Agent's NamPIC T Date ACTION DATE BY ECLARATION OF COMPLIANCE WITH CODE OF FEDERA OR OFFICE USE ONLY �lllREGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED ❑AQM D PERMIT FINAL , t-S !1 (� ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF ,` PROPOSED D MOUTION OCCUPANCYISSUED SIGNATUR