The URL can be used to link to this page

Home My WebLink AboutX2021-3103 - PermitsCity of Newport Beach - Building Division *X2021 -3103* COMB Permit: X2021-3103 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1624-2021 Permit Counter Phone (949)644-3288 u - Inspection Requests Phone (949)644-3255 N I �? r �'�� +"'� Issued Date : 1111612021 h�t,viSY�c> Combination Type - BLDG ELEC PLUM < - �' x ' °� �'"� 6 4,3t Inspection Area : 3 PERMIT EXPIRES 160 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1111612024 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: 2001 CENTELLA PL NB Description: DELTA 2 REVISION: ADD BUILT-IN BBQ W/ GAS & ELEC LINES TO SCOPE Legal Desc.: N TR 3379 LOT 1 Owner: SACKMAN PAUL Contractor: OWNER/BLDR Architect: Address: 204 ONYX AVE Address: SACKMAN PAUL Address: ' NEWPORT BEACH CA 92663 0/8 FORM ATTACHED ^ Phone: Phone: 949-533-3751 Phone: State Lie: Applicant: SACKMAN PAUL Con State Lie: 0113 Engineer: Address: 204 ONYX AVE Lie Expire: Address: NEWPORT BEACH, CA 92662 Bus Lie: Phone: 949-533-3751 Lie Exp Date: Phone: State Lie: Code Edit: 2019 Worker's Compensation Insurance Designer: SACKMAN PAUL Type of Construction: Carrier: Address: 204 ONYX AVE - Occupancy Group: U Policy No: NEWPORT BEACH, CA 92662 Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: REV21-1803 No of Units : 0 Front: / Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Hood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $900.00 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 : $52.00 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: $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 PNJ 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 %: $9.90 $0.00 TOTAL FEE : $278.30 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $278.30 PROCESSED BY: (53 ZONING APPROVAL: M f IN GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: `_r 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 :he 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 Irofessions 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 U all of or U 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 map ved for the purpose of sale). ILsl I, as owner of the oroperty, 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 p.aperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). Q ' cr.a exempt from icensure 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 legally sdll a structure thpt I have built as an owner -builder if it t been c9pistructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 7rofi, sions Code, is available upon request when thi; ap li tired ubmi d or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi. d Signature of Properly Owner or Authorized Agent _� wd,� Date /- //- /G ^ Z 1 1(:F.NSED CONTRACTOR'S DECLARATION I hprnhy affirm'Inver penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION AAHNING FAILURE TO PEC9RE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSf.T:ON, LAMAGES 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: D 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 th performance of the work for which this permit is issued. Policy No. ❑I have 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 compensatiol insurance carrier and policy number are: Policy Number Date ne of Agent 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 I. if I should become subje the w/g/(ke ort}pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicants yDate CLARATION REGARDING CONS UCTION LENDING AGENCY �reby affirm under penalty of perjury that there is a construction lending agency forthe performance of the work for which this permit is issued (Section 3097, 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 gtate laws relating to building construction. I authorize representatives of this city or county to/en ey th_.ov Ida Pied property for inspection purposes. 'PAS nature of Property Owner or Authorized Aoent k I Print Property Owner's or Authorized Agent's Name A DATE BY RDECLARATION IEGULATIONS PART COM LIANF TIT E CE ITH AND DE OF RULE FOR OFFICE USE ONLY PERMITEXPIRED LI I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LIEPA PERMITEXTENDED QMD PERMIT FINAL ASBESTOS NOTIFICATION IS N TAPPLICABLE TO CERTIFICATE OF .11 •11 PROPOSED DE OL OCCUPANCY ISSUED SIGNATURE: Civil Code). 5/tC LC w e-nJ Z/