HomeMy WebLinkAboutX2020-2835 - PermitsM.
City of Newport Beach - Building Division *X2020-2835* COMB Permit: X2020-2835
100 Civic Center Drive, Newpbrti%seeh, CA 92660 Project No: 2242-2020
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
" 4a ':,fyrrrxNa* Combination Type - MFP MECH ELEC PLUM Issued Date : 01/0812021
Inspection Area : 4
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 01/09/2024 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 Hol{dys
Job Address: 2133 VISTA ENTRADA INS �A ^
Description: MFR REMODEL (E) MASTER BATH 40 SF (INCLUDES WATER HEATER) Veb
Legal Desc.: TR 5878 (L.L.84-214031) PAR 28
Owner: MELZERIWARE Contractor: OWNER/BLDR Architect: MELZER MARK HENRY
Address: 2133 VISTA ENTRADA Address: MELZER MARK Address: 9511 IRVINE CENTER DR
NEWPORT BEACH, CA 92660 O/B FORM ATTACHED IRVINE CA 92618
Phone: Phone: Phone: 949-474-8188 State Lic:C017918
Applicant:
MELZER MARK HENRY
Address:
9511 IRVINE CENTER DR
IRVINE CA 92618
Phone:
949-474-8188
Code Edit: 2019
Type of Construction: VB
Occupancy Group: R2/U
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units: 4
Bldg Height: 0
Bldg Sprinklers: N
Construction Valuation:
Building Permit Fee: $161.00
Plan Check Fee: $140.07
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$2.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $382.52
PROCESSED BY:
ZONING APPROVAL:
Con State Lic: OIB
Lie Expire:
Bus Lie:
Lie Exp Date:
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. I
Front: I
Left: I
Right: I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$11.27
$6.44
$14.49
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Planning Department -
Plan check Fee:
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
P/W Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
State Lie: - .. .. ..
Fire Department
$46.25
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee : $186.32 Fee Due at Permit II(s�suance (1
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$196.20
OWNER -BUILDER DECLARATION r� v
1 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 (_) 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
i provements 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
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
y t0 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:
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 legall,
sell a structure that I have built as an owner -builder if it hasp6t been constructed in its an rety by licensed contractors. I understand that a copy of the applicable law, Section 70 of the Business and
Professions Code, is available upon request when this a (cation u r 9�t q f�Ipylln eb site:htt //www.le info.ca. ovlcalaw.htmi.
Signature of Property Owner or Authorized Agent 11LA/7/I rVV p g g e
LICENSED CONTRACTOR'S DECLARATION
1 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
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: 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 ($100,000), IN ADDITION TO THE
rOST OF ^OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm rdjr renalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thI
erfo-mance of the work for which this permit is issued. Policy No.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
rer,ce carrier and policy number are:
ibr
ie of Agent
Policy Number Expiration Date
Phone #
;erti; y that, in1he performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
if I should be>ime Subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
npretvre of Aprlin^rt Date__
)ECLARATION REGAkDING CONSTRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name Lender's Address
ly my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
1 agree to comply with all applicable city and county ordinan as an state laws r ating to building construction.
I authorize representatives of this city or county t ter t�Ie�tlgvg�5)enjif�ec$ p ,fo inspection purposes. X ♦, ,H I, A A V
of Prooertv Owner or Authorized
ACTION
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
I DATE I BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDEI
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
ISNOTAPPLICABLE TO
FOR OFFICE USE ONLY
Date
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