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Home My WebLink AboutX2018-3180 - Permitssna111Y"% City of Newport Beach - Buildin .•� a� 100 Civic Center Drive, Newport Beach, CA 92660 F Permit Counter Phone (949)644-3288 u @ Inspection Requests Phone (949)644-3255 1 r:d,ri14p.* Combination Type - MFP PLUM Division *X2018-3180* Z COMB Permit: X2018-3180 If1aPAif6P41?Ji2018 r� C '� 0n�`r 51 GG% reft rr . to A YSFGFTiER IS - E VWLIU nvo Construction Hours: Monday •Friday f:00 a� m ,x� p. ron 6 rkr i�fo id �� Job Address: 509 MORNING CANYON RD NB 9 T 0 Description: MFR PEX REPIPE Legal Desc.: TR 12079 LOT 1 UNIT 12 OF PROJECT LOCATED ON A 459-1M, TOG" g Owner: RUSSELL JOHN Cohbacfn' �C Address: 509 MORNING CANYON RD Address -;;EA CAP0#3 I jddi' :� NOW CORONA DEL MAR, CA 92625 /" Phone: Phone: 714-618-2633 Phone: State Lic: Applicant: NUNEZ AMPELIO Con St .Lic:. 8 41 Engineer: ' Address: 2500 E IMPERIAL HWY #213 Lid Expire. r O il�Al9.�-a cry v-.. d .•...�+ Addresw r� BREA CA 92821 Buis Lic: 3 - - - Phone: 714-61 B-2633 Lic Ex ate`:` 0 12 19 a i `� i Phone: �r _ �.A Ic '' �"'�fd£e Lic: Code Edit: 2016 Worker's Compensation Insl�`rancek Siarted) Designer (no work started) Type of Construction: V-B Carrier: TRUCK INSURANCE Address: " Occupancy Group: R2 Policy No: I. A09473256 •'� Added /New sq.ft. Bldg: 0 Expire: Added /New sq. ft. Garage: 0 FF • . No of Stories: 2 Building Setbacks- Bear I Special Conditions: Insp. Initials: No of Units : 1 Front: 1 Bldg Height: 0 Le Bldg Sprinklers: Right: I Flood Zone: Use Zone: Parkino Soaces: 0 Fire Hazard Zone : N Valuation: Building Permit Fee: $120.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $131.80 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax: $0.00 Planning Department - Fire Department Additional Fee : $0.00 Plan check Fee: $0.00 Fire Inspection: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 WQ Insp. Fee : $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Electrical %: $0.00 San Dist : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbin ° : M;r $10.80 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $131.80 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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 far 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 (_) all of or (_) 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 legall) 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 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. Signature of PraaPr'y ( Iwner or Authorized Agent Date ! ICENSED CONTRACTOR'S DECLARATION nereo� affirm Diwer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7s0 of 'vi i n of the Business and Professio - -license is -in -full force and effect. Liceaja lass License No Da=ap� Sontractor Signature 4VU,RKERS' COMPENSATION DECLARATION WARNING: FAILURE` TO SECURE WORKERS' 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 00, 7OR COMPENSATION,-9AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and wi.l 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 th Performance of tho work for which this permit is issued. Policy No. _a?'e and .01 rnpiiltain 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' compensatio yrance carrier and policy number are: n[Ier' - - Policy Number Expiration Date me of Agent Phone # 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 agm t, if I should become subject to-the-V - Lion `rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nt _ nature of ApplicaDate CLARATION R GAYDING CONSTRUCTION LENDING AGENCY areby affirm under ftnalty 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). 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 owner's behalf. I have read this application and the information I have 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,eRfer-tke-ebeve-i 'ed-p for inspection purposes.`//, /�„ /�� Date } inature of Prooertv Owner or Authorized Aqent Print Property Owners or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CObE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMITEXPIRED _ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED OEPA PERMIT EMENDED QMD PERMITFINAL �I �N l l9 (7 1 S ESTOS NOTIFICATION 15 NOT APPLICABLE 70 CERTIFICATE OF Y D IT OCCUPANCY155UE0 / �z SIGNATURE• ice/