HomeMy WebLinkAboutH2022-0388 - Permits�E.wPoR� City of Newport Beach III I I I II I II I II IIII�i II I II
Community Development Department- Building Division -
> 100 Civic Center Drive, Newport Beach, CA 92660
i Permit Counter Phone: (949) 6443288
Inspection Requests Phone: (949) 644-3255 T�
` c9<icoa"'P newportbeachca.gov/inspecfonsNoll
Permit: H2022-0388
Plan Check No : 0310-2022
Work Class : Other
Issued Date : 07/29/2022
Inspection Area : 6
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 520 IRIS AVE Legal Desc : A TR CORONA DEL MAR BLK1536 LOT 22
Description: MECH INSTALL AC **TAMPER -RESISTANT CAPS**
Owner:
Address
Phone:
Applicant
Address
Phone:
TOM MILLER
Contractor :
JOHN MASTROPAOLO CONSTRUCTION
520 IRIS AVE CORONA DEL MAR, CA 92625
Address:
16291 MAGELLAN LANE HUNTINGTON BEACH, CA 92647
Phone:
(562) 200 1024
Con State.Lic
: 975340
JOHN MASTROPAOLO CnNSTRI ICTION
LiIc E '
07/31/2022
16291 MAGELLAN LANE
(562)200-1024
Owner/Builder:
Address
Phone:
Code Edition :
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY
xplre .
N BEACH 'CA 92647 Bus Lic : BT30075965
Bus Lic Expire:07131/2022
Workers' Compensation Insurance
Carrier :
Policy No: EXEMPT
W. C. Expire:
2019 Fire Sprinklers : NO Manufacturer: GOODMAN
Fire Hazard Zone : N Model# : GSX160481 F
Front: 10, Side: 3, Side: 3, Rear 5
X
R-2 - Two -Unit Residential
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LEER DECLARATION
under penalty of parjury that] am exempt from the Contractors' State License Law for the reason(s) indi,
usiness and Professions Code: Any city or county that requires a permit to construct, alter, improve, der
4oess and Professions Code. The Contractors' State License Law does not apply to an: owner of property who, tin
Movements are not intended or offered for sale. If, however, the building or improvement is sold within one year o'.
(roved. for the purposeof sale)..
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section
Ay town owner of property who builds or improves: thereon, and who contracts for theprotects with a licensed Con
I am exempt from licensure under the Contractors' State License Law for the following reason:
my signature below I acknowledge that, except for my personal residence in which I must have resided for at leas
below by the checkmark(s) I I
,or repair any structure, prior
and
v of
builds or improves the property, provided (hat tha
have the burden of proving that It Was not built or
Business and Professions Code-, The Contractors State License Law does not
pursuant to the Contractors' State License Law).
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7006 f Div ton3 of the Business and -Profess �CodVa d my license is in full force
and effecrL License Class License No Date. Contractor Signature rr.L� I
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND: SHALL SUBJECT AN EMPLOYER TO CRIMINAL: PENALTIES AND CIVIL PINES UP TO, ONE HUNDRED. OUSAND DOLLARS (15100,00e), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY-S FEES.
hereby affirm under penalty of perjury one of the following declaraiios:
1 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 tn,.
jerlomnance Of
-Ifhave and will maintain{workers' compensation sat'ion insurance,
, as required b Section 3700 of the Labor Code; for th$
which this permit Is issued. Policy
p required y performance of the work for which this permit is issued. My workers! Gompensatiol
nsurance carrier and policy number are:-
y Expiration Date
Narp
V Agent
,Uriii certify y that, In the performance of the work for which this permit is issued, I shall not employ an person in a man become
Phone t#
6i1 tY p p p y y p any tier so as. to become subject is the workers' compensation laws of California, and agra
that, if I should become subje the rkers' compensation provisions of Section 3700 of the Labor Code, I shalt forth rith comply with those provisions. u'C
Signature of Applicant [SafB� f Div
DECLARATION REQA DtN NSTRt1CTtON LENDING. AGENCY '
1 hereby affirm Tinder pens f 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. Lenders:. Address
By my signature below, I certify ro each of the following,
I am the property owner or authorized to act on the property ownees behalf.
Signature of PIC e e OWntO eor Ruthonzetl Acout ty to t thect ;anddenl fie property folnPrintltPrope Purposes.
or �� e
I have repdtfifs lication and the information I have provided is correct.
thorize
s of
s city
I : ree to ybtYtt9ly with all applicable 7 �j
(Authorized A ent's Name Date! `
ACj'A DATE BY pECLARAT[ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE QNLY
REGULATIONS PART 61 OF TITLE AO AND AOMD RULE
♦s c •a^• 1403
PERMIT EXPIRF01 01SUBMiTTE'D ASBESTOS NOTIFICATION. TO
P RMRp •. EPA All required alarms, latches gates and fences which serve aspart ofapool/spa -:barrier, shall
� Rrla£T EXTENOEt'7LIAQMD be In place priorto approval to fill pool/spa &:shall remain in place & be maintained forthe
PtRMQ E)NA! A . . AS8EST05 NOTIFICATION tS NOT APPU -ABLE TO loft Of the pool.
PC lT(F(CATE OF ^2g '� D�}\ I PROPOSED DEMOLITION.
(i!/Y filATl('V fCt19i(1 �� I CIYt1.AT t�C..
PERMIT FEE DETAILS FOR PERMIT H2O22-0388
Fee Name Fee Amount Fee Paid Amount
Transaction Date Payment Method Trans. Paid Amount Paid By
Building
Boilers and Compressors 4-15 HP Fee $40.00 $0.00
Building Plan Check Fee $34.80 `,. $0.00
Issuance Fee .$39.00 $0.00
OTC Plan Check Fee - Planning $53.00 $0.00:
GRAND TOTAL: $166.80