HomeMy WebLinkAboutX2019-1188 - Permits,$ City of Newport Beach - Building Division
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COMB Permit: X2019-1188
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2
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8
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100 Civic Center. Newport Beach, CA 92660
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Project No
Permit Counter Phone (949)644-3288
0
at Inspection Requests Phone (949)644-3255
"'� ". Combination Type - GRAD
Issued Date : 04/15/2019
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Inspection Area : 5
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: 427 IRIS AVE NB
Description: SFR -CITY STANDARD DRAINAGE/NEW DRIVEWAY
Legal Desc.: CORONA DEL MAR BLK 435 LOT 11
-
Owner: ORTIZ EDWARD - Contractor:
P V M
Architect:
-
Address: 427 IRIS AV Address:
15643 PESCADOS DRIVE
Address:
CDM CA 92625 -
LA MIRADA CA 90638
Phone: Phone:
714-736.0477
Phone:
State Lie:
Applicant: P V M Con State Lie:. 432966
Engineer:
Address: 15643-PESCADOS DRIVE Lie Expire:.
.03/31/2021
Address:
LA MIRADA-CA90638 Bus Lie:
BT30066906
Phone: 714-736-0477. Lie Exp Date:
04130/2020
Phone:
State Lic:
Code Edit `. 2016 Worker's Compensation Insurance
Type of Construction: Carrier: STATE COMP
Designer.
Address:
1 ;
Occupancy Group: U Policy No:
9069136
Added /New sq.ft. Bldg:. 0 Expire:
12/01/2019
Phone:
Added /New sq.. ft. Garage: 0
No of Stories: 0 Building Setbacks
Rear:. /
Special Conditions:
No of Wts :. EFS ° . 0.
Front: /
Bldg Heiglit: c = 0
Left: /
Bldg S°p?irtklers: °
Right: /
FI o Zoft`e: Use Zone:
Parking Spaces:
0
Fire Hazard Zone : N
onstruction Valuation: $10.000.00
Buildirag Permit'Fe2 ' ° $232.00 Excise Tax:
$0.00
Planning Department -
Fire Department
Plan,Qheck Feg ° ° $9.00 Additional Fee :
$0.00.
Plan check Fee :
$0.00
- Fire Inspection:
$0.00
Uy@rtipfa Plan tC:� ° ° $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 Managemont: $0.00 Grading Permit Fee:
$312.00
In-lieu Housing Fee:
$0.00
Building Dept Adm
$0.00
Energ°y Complianom ° ° $0.00 - Grading PC Fee:
$312.00
Public Works Department
-
General Service
$0.00
J)s1°S,ej€mic Safety, � $0.00 WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
$0.00
Disabled Access,:, c � $0.00
PNV Plan Check :
$0.00
Grading Bond:
$0.00
Hazardous Mat° '000. $0.00 Electrical %:
$0.00..
San Dist:
$0.00
Building Green Fee : $1.00.. Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $857.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance : $857.00
PROCESSED BY: - PUBLIC WORKS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE: -
OWNER -BUILDER
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
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
iot more than five hundred dollars ($500).
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
n roved 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).
3 1 am exempt from licensure under the Contractors' State License Law for the following reason:
ly my signature below 1 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 legally
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
Irofessions 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 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) Diviskm 3 of the Business and Pr pj �ns.Gode-end�ny-Iicense is in full force
nd effect. License Class License No Date - 1% Contractor Signatur
YORKERS' COMPENSATION DECLARATION
IARNING: 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 15100,0001, IN ADDITION TO THE
OST 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 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 IN
e rmance of the work for which this permit is issued. Policy No.
�I ave 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' compensation
Is ante carrier and policy number are:
:artier Policy Number Expiration Date • • • ' _ri��
lame 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, aKd agroe
sat, if I should become subjee workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Da
signature of Applica t
IECLARATION REG DiN STRUCTIO LLENDING AGENCY
hereby affirm under penalty 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). • • • • • o ° o `
ender's Name Lender's Address
Iy. 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 "" ; ° ° ° ° o
I agree to comply with all applicable city and cou rdmances and state laws relating to building construction. , • • • •,
I authorize representatives of this city or county 'R a abov = ntified property for inspection purposes. r^� • • • •. _I
ianature of Procertv Owner or Authorized ADent Print Property Owner's or Authorized Agent's Nam�i--�r%3.�.f�- hnCu Date ` f / I f
ACTION
DATE
BY V
\DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMITEXPIRED
0 I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED
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PERMIT EXTENDED
qMD
PERMITFINAL
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF
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PROPOSED DEMOLITION
OCCUPANCY ISSUED
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