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Home My WebLink AboutX2015-3498 - Permits�Err'y4 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2015-3498 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 5 3 4 9 a Project No : 2633-2015 F ^� Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 n r qis Combination Type - BLDG ELEC PLUM Issued Date : Inspection Arearea :2015 6 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Job Address: 16 TASMAN SEA NB Description: NEW FIRE WALLIFEATURE 4'-6" H X 9 LF (INSIDE P/L) A ZIVNN Legal Desc.: r S - Owner: HAIRAPETIAN ARMOND & ELENA Contractor: E M LANDSCAPE POOLS & SPAS Architect: Y g' Address: 16 TASMAN SEA Address: 17537 DEER VALLEY COURT Address: NEWPORT COAST CA 92657 RIVERSIDE CA 92504 Phone: Phone: 949-547-2657 Phone: State Lic: Applicant: MONCADA ERNESTO Con State Lic: 848437 Engineer: LACHER TODD Address: 17637 DEER VALLEY CT Lic Expire: 02/28/2017 Address: 1201 N TUSTIN AVE , RIVERSIDE CA 92504 Bus Lic: BT30053294 ANAHEIM CA 92807 Phone: 949-547-2657 Lic Exp Date: 1113012016 Phone: 714-630-6100 State Lic:C-067656 - Code Edit : 2013 Worker's Compensation Insurance Designer: Type of Construction: Carrier: OAKRIVER INS Address: , Occupancy Group: U Policy No: EMWC601404 - Added /New sq.ft. Bldg: 0 Expire: 12101/2015 Phone: Added /New sq. ft. Garage: 0 - No of Stories: 0 Building Setbacks Rear: / Special Conditions: No of Units: 0 Front: / Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $2,500.00 Building Permit Fee: $110.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $95.70 Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 Overtime Plan Ck: $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 : $0,01 Refund Deposit $0.00 Disabled Access : $0.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $7.70 San Dist : $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $990 $0.00 TOTAL FEE: $224.30 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $0.00 Fee Due at Permit Issuance : $224.30 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 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) (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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 legal) sell 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 Professions 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 LICENSED CUA TR,l,CTOR'S DECLARATION I' hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) pf Division 3 f the Business and Professions_ Code And my lips in full force and effete. Liccrs3 Cliss License No Date Contractor Signatures WORKERS' COMPENSATION DECLARATION &ARNIN'u: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUB.IECT AN EMPLOYER TO CRIMINAL PEN LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I: hereby affirm undei penalty of perjury one of the following declarations: C : ;rave and Nill 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 l'e4;�ance of the work for which this permit is issued. Policy No. ill j ay.. 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' compensatio i. ipdranca carrier avid pDlicy number are: Policy Number Ie of Agent;_ Date 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applican CLARATION RE DIN CONSTRUCTION LENDING AGENCY Ireby affirm unde enalty 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). Ider's Name Lender's Address 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 to enter the above -identified property for inspection purposes. /s __C � nature of Property Owner or Authorized Agent • Print Property Owner's or Authorized Agent's Namg lam' D e Ae7WW nATF BY DECLARATION OF COMPLIANCE AgTFl CODE OF I-M of -mu ust UMLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AOUD RULE 1403. PFR,rorrT FYPIPFf) ❑ I Sfin fTrrn,&snr'ST17S w)TirH'ATION TII: ❑ EPA ❑ ACIME, 2CRVTT CAPPCaLM PFRbfrTEYTEhrE0 0 ASBESTOS N077RCA77ONiS NOT APPLICABLE TO PROPOSEI)GEMOUTION_ PLR1vJ1T rIPIAL i b C� CERT,FICATEC'F SIGNA I UHL: OCCUDAIdC'r. SSL'E_t