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HomeMy WebLinkAboutX2019-0356 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2019-0356 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 0 3 5 6 Project NOPermit Counter Phone (949)644-3286Inspection a Requests Phone.(949)644-3255 Combination Type - MFP PLUM - _ Issued Date: 0113012019 .. Inspection Area : 4 PERMITS EXPIRE. 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 109 BAY HILL DR NB Description: MFR - PEX RE -PIPE 11 FIXTURES Legal Desc.: TRACT 12105 LOT 1 OF PROJECT 931-79 LOCATED ON AP 442.033.04 9 � r y r Owner ELAM MARY KAY Contractor. REPIPE 1 Architect ; �� % Address: 109 BAY HILL DR Address: 19326 VENTURA BLVD #201 Address: F o+• a NEWPORT BEACH, CA 92660 TARZANA CA 91356 ' o msem°o Phone: .949.5334613. Phone: 818-342-2927 Phone: State Lie: ; e. mo • ° ` Applicant:. REPIPE1. Con State tic: 927892 Engineer. • °ee°mo Address: 19326 VENTURA BLVD #201 Lie Expire: 01/3112021 Address: e • a ° TARZANA CA 91356 Bus Lie: BT30044924 ° o m' e o • o Phone: 818-342-2927 Lie Exp Date:. 10/3112019 : Phone: e e" State Lie: e •mama Code Edit: 2016 Worker's Compensation Insurance ` Designer. Type of Construction: V -B - Carrier: INS CO OF THE WEST Address:. • a e m m ° c Occupancy Group: R21U Policy No: - CST6013781. Added /New sq.ft. Bldg: 0 Expire: 09116/2019 Phone; Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units : 6 Front: / Bldg Height: 0 Left: Bldg Sprinklers; Right: Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $6.500.00. Building Permit Fee: $184.00 Excise Tax: $0.00. Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: .$0.00. Fair Share: $0.00: Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans'. $0.00 Demolition Fee Record Management; $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $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 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan .Check: $0.00 .Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 - San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 - $0.00 Plumbing W. $16.56. $0.00 TOTAL FEE : $ 1.56 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $201.56 PROCESSED BY: PUBLIC WORKS AP OVAL: ZONING APPROVAL: PLAN CHECK B GRADING APPROVAL: APPROVAL TO ISSU 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, of 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). ❑ I am exempt jro mlicensure under the Contractors' State License Law for the following reason: By my signature below.) 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) pgll a s&ucture tltaT T 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 rofes's'ions Cq*,ys. vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. %gnajure of Property dwner or Authorized Agent Date ICAMED CONTRACTOR'S DECLARATION hereby affirm.underpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 )_ f Division 3 of the Business and Pro ins Code, nd my license is in II force rM e�ifect. LiQrrlhg�OAass License No -0ate / r Y�. /O� Contractor Signature WPAKERS' COMPENSATION DECLARATION -� ARNING: FAILURE J(J%EbURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (11100,000), IN ADDITION TO THE LTS*r'OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 19$Ls qy affirm under penalty of perjury one of the following declarations: I� ave anV&l? hjaintain 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 3e r�nsince oft work for which this permit is issued. Policy No. •. a and willanamtain 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 insuranc carrier and policy number are: Carrier Policy Number Expiration Date Yam 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 sub'ect to the y� rkers' compensations of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / > p/ Signature of Applicant 3/�J/ Date ` ' 7 © ' DECLARATION REGA DIN CONSTRUCTION LENDING AGENCY - �. I hereby affirm under, nalty 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). Lender's 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. 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 t to a above-identified pro y for inspection purposes. Signature of PropertyOwner or Authorized Agent Print Property Owner's or Authorized Agent's Name '✓ r' l� `' r Da rCJ T ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMIT-FED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED LJAQMD PERMITFINAL q ASBESTOS NOTIFICATION IS OT APPLICABLE TO CERTIFICATE OF 5' 1' PROPOSED DEMOLITIO OCCUPANCYISSUED VVV SIGNATURE: