HomeMy WebLinkAboutF2018-0245 - Permits}
w City of Newport Beach - Building Division
- 100 Civic Center Drive, Newport Beach, CA 92660
' Permit Counter Phone (949)644-3288
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Job Address: 429 MARIGOLD AVE NB
Inspector Area: 5
Owner: MSW CDM LLC
Address: 429 MARIGOLD AVE
CORONA DEL MAR, CA 92625
Phone:
Applicant: CASEY MONTY
Address: 1101 KINGSTON DR
LA HARBRA CA 90631
Phone: 714.476-5370
Lie Exp Date:
Code Edit : 2016
Worker's Compensation Insurance
Type of Construction:
V-BSPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
3
No of Units :
0
Flood Zone:
$0.00
Bldg Sprinklers:
Y
VII IIIIIVIIIIIIII1IIIIIIIIII 0 II4III II
Description: NEW SFR FIRE
Legal Description: CORONA DEL MAR BLK 439 LOT 21
Contractor: FIREPROOF FIRE PROTECTION
Address: 1101 KINGSTON DR
LA HABRA CA 90631
Phone: 714.476-5370
Con State Lie: 676004
Lie Expire: 04/3012020
Bus Lic:
BT30040107
Lie Exp Date:
08131/2018
Worker's Compensation Insurance
Carrier:
NORGUARD INS CO
Policy No:
MOWC901180
Expire:
02/15/2019
Issued Date: 04/2512016
Setback- Front:
Rear:
Left:
Right:
FIRE Permit: F2018-0245
Project No: 0969-2018
Inspection ReAuests Phone (949)644-3255
l HEA ) X2017.3054
t
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
State Lie:
State Lie:
CASEY MONTY
1101 KINGSTON RD
LA HABRA CA 90631
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
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Construction Valuation:
$3,200.00
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Building PC Fee :
- $190.00
Fire Residential Alarm PC Fee:
$0.00 Records Management:
$4.00
Building Overtime PC Fee:
$0.00
Planning Counter Review:
$0.00
Building Extention Fee:
$0.00
Planning Zoning PC Fee :
$0.00
....
Building Investigation Fee:
$0.00
°$0100
Fire Plan Check Fee:
$0.00
Public Works PC Fee:
$0.00
$0.00 °
Fire Permit Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
° °
Building Permit Fee :
$225.00
TOTAL FEE :
$419.00
Plan Check Fee:
$419.00 Fee Due at Permit Issuance :
° ° ° °$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(s)
lection 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
is 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
'rofessions 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
of more than five hundred dollars ($500).
1 I, 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,
lusiness 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
nprovements 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
nproved 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
pply 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:
ly 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,
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and m license is in full force
nd effect.
!cense Class License No Dat Contractor Signal
IIORKERS' COMPENSATION DECLARATION
'ARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA((57 DDB), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. -
ereby affirm under penalty of perjury one of the following declarations:
I have and will 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
erfante of the work for which this permit is issued. Policy No.
�I h e 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' compensatioi
Isura ce carrier and policy number are:
Policy Number Expiration Date
le of Agent Phone u
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
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. _
of
)ECLARATION REGOIAN VeNSTRUCTIONDING AGENCY V Ir
hereby affirm under penalty of perjury that ther s construction lending agency for the performance of the work for which this permit is issue (Section 3097, Civil Code).
.ender's Name... • Lender's Address
ly my signatute 6Wlo , I certify to each of the following:
1 y4i the propeafy owner or authorized to act on the property owner's behalf.
I h2ve read 01s•application and the information I have provided is correct.
• I agree to corryply with all applicable city and county ordinances and state laws r 'ting to building construction.
bauthorize rW%wntatives of this city or county tg,encctte��r the above -identified pr erty for inspection purposes. ^� r
Signature of PfterW.dwner or Authorized ADen \�` rZ Print Property Owner's or Authorized Agent's Name\
A6D6N • DATE BY DECLARATION OF COMPLIANCEINITM CODEOF \ FOR OFFICE USE ONLY
'•'. • •• FEDERAL REGULATIONS PART 61 OFT17LE40AND \
ERMITEXP{REf) AQMD RULE 1403.
... • ❑ t SUBMITTEDASBESTOS NO7tFICATION TO:
PER. ITC4W,iE L£B: ❑ EPA
❑ AQMD
OCCUPANCYISSUED
SIGNATURE:
NOT APPLICABLE TO
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