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Home My WebLink AboutX2021-1340 - Permitsr�t�/� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit. X2021-1340 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 1 3 4 0 Project No 4.:, Permit Counter Phone (949)644-3286 X'2-021 . 4r Inspection Requests Phone (949)644-3255 -15L+ 0 4'.,cA,y+ Combination Type - GRAD �A Issued Date : 05/2512021 I" t 6� I ( 1j V1 C., f Inspection Area : 6 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0512512024 OR PERMIT WILL BE INVALID 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: 8 MALIBU CIR NB Description: DRAINAGE PER CITY STANDARD - Legal Desc.: N TR 7432 LOT 24 Owner: COOPER MARTIN L & CYNTHIA S Contractor: SYSTEM PAVERS Architect: 16 �9g�p' E:')� P lZCT�!UOD Address: 8 MALIBU CIR Address: 1570 BROOKHOLLOW DR Address: CORONA DEL MAR, CA 92625 SANTA ANA CA 92705 Phone: 949-933-5795 Phone: 949-263-8300 Phone: State Lic: Applicant: SALCEDO SAM Con State Lic: 661575 Engineer Address: 1570 BROOKHOLLOW DR Lic Expire: 1213112022 Address: .... SANTA ANA CA 92705 Bus Lic: BT00016080 ...... Phone: 949.263-8300 Lic Exp Date: 10/31/2021 Phone: State Lic: • ,. . •.m amoco< Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: EVEREST NATIONAL INS Address: Occupancy Group: u Policy No: CA10001490211 Added /New sq.ft. Bldg: 0 Expire: 02/11/2022 Phone: Added /New sq. ft. Garage: 0 0 ° �, ° ° • • . o° No of Stories: 0 Building Setbacks Rear: 10 Special Conditions: No of Units: 0 Front: 10 Bldg Height: 0 Left: 5 Bldg Sprinklers: Right: 5 Flood Zone: Use Zone: PC Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $0.00 Building Permit Fee: $0.00 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: $2.00 Grading Permit Fee: $232.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $0.00 Grading PC Fee: $195.00 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 P/W Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 lumbing %: $0.00 $0.00 TOTAL FEE : $46 Plan Check Fee : $0.00 Fee Due at P ssuance : $429.00 PROCESSED BY: PUBLIC WORKS APPRO AL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: _. _ 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) 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 1, as owner of the property, or my employees with wages as their sole compensation, will do `) all of or L) 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). 1 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). I 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://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirmylpd®r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) o, Division 3 of the Business and Pro as `ins C e,�and IyyY licence is in full force nd effect. N ceprSg Class License No Date _ Contractor Signature �f � 9O t(ERS'.C.QKFIENSATION DECLARATION DARNING: FA U.JETQ $CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE OSTOFCOMP SATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. he1gpy affirm under penalty of perjury one of the following declarations: ve and' yvjlPm$intain 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 effp ° ce of the pork for which this permit is issued. Policy No. 191je and Qvill'raaimain 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' compensatiol Isupan carrier and policy number are: Policy Number Expiration Date lame of Agent' • : Phone # kce'rtly that, Pipp p$rformance 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 191` TF1 should 6ecome°subjectto the w ers' com s on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Date 5"" 25- 2 IECLARATION REGAR ING CONSTRUCTION LENDING AGENCY hereby affirm under pe ally 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). 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 owners 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 toter the -112 ive-identif!pP,Egpel>for inspection purposes. ACTION PERMIT EXPIRED PERMITCANCELLED PERMITEXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED DATE BY t DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBESTOS LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION Zf SIGNATURE: vner's or Authorized Aa FOR OFFICE USE ONLY