HomeMy WebLinkAboutX2021-1886 - PermitscrYR,=Vrfr City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC MECH PLUM
IIIIIIIIIIIIIIIIIIII IIIIIIII�III� II COMB Permit: X2021-1886
Project No: 1624-2021
Issued Date : 08/2512021
Inspection Area : 3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09/25/2024 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: SFR - KITCHEN AND BATH REMODEL INCLUDING WINDOW REPLACEMENT 1600 SF
Legal Desc.: N TR 3379 LOT 1
Owner:
SACKMAN PAUL
Address:
204 ONYX AVE
NEWPORT BEACH CA 92663
Phone:
Applicant:
MILLER RON
Address:
2110 MONROVIA AVE
COSTA MESA CA 92627
Phone:
9491385-3745
Code Edit: 2019
Type of Construction: V-B
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 2
No of Units: 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone: X
Construction Valuation: $100,000.00
Building Permit Fee: $1,209.00
Plan Check Fee:$1,051.83
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$28.00
Energy Compliance:
$70.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$4.00
TOTAL FEE: $2,758.13
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor
Address:
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
OWNER/BLDR
SACKMAN PAUL
0/8 AUTH ATT
949-533-3751
O/B
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: /
Left: /
Right: /
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$84.63
$48.36
$108.81
Architect:
MITCHELL JASON
Address:
5100 WILSHIRE BLVD,#409
LOS ANGELES, CA
90036
Phone:
State Lic:CO3CrydP2
L
Engineer:
DAD, VINH HUU
Address:
13191 DEAN ST
TUSTIN CA 92780
�+�'�
Phone:
State Lic:C-0780
Designer:
Address:
` J
Phone:
Special Conditions:
X
Fire Hazard Zone : N
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication : $0.00
PNV Plan Check : $101.50
San Dist : $0.00
NMUSD Fee: $0.00
Fire Department
$52.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $1,154.58 Fee Due at Permit Issuance : $1,603.55
_ PUBLIC WORKS APPROVAL: `yltpr,1 1V,/
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
: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
Orofessions Cade) 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
rot 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 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
WIoved 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).
❑ I am exempt from Iicensure 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
sell a structure that I have built as an owner -builder if' s not been cons tr tad iI 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 tips a p catio su Itted at the following Web site:http://www.leginfo.ca.gov/calaw.html. 6 !+
Signature Lf Prgpe.-ty Owner or Authorized Agent / Date
LICENSED CONTRACTOR'S DECLARATII�
I hereby affirm under 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
aid effect. License Class License No Date Contractor Signature
'/CORKERS' COMPENSATION DECLARATION
NARNING: F. JLUPE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
C06T OF COMP�NSA-ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby af5:ci under penalty of perjury one of the following declarations:
111 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.
D have and wil! 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
i-,curance carrier and policy number are:
Policy Number
Date
ie 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
, 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 Applicant Date_
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
�reby affirm under penalty of perjurythat there is a construction lending agency forthe 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 fallowing:
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 or In ces d s to la ng o ul onstruction.
I authorize representatives of this city or county to nt r e I property for inspection p oses.
nature of Property Owner or Authorized Agent �, i Pro wner's or Authorized Agent's Name 17�14L O�'i%f�"� Date
DATE BY DECLARA ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGU IONS PART 61 OF TITLE 40 AND AQMD RULE
NOTIFICATION TO
PERMIT CANCELLED
PERMIT EXTENDED
PERMITFINAL
CERTIFICATEOF
OCCUPANCYISSUED
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