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Home My WebLink AboutX2021-1097 - Permits�wt�, City of Newport Beach - Building Division *X20211097* COMB Permit: X2021-1097 -i ±. 100 Civic Center Drive, Newport Beach, CA 92660 �+ Project No �, '�: `%� Permit Counter Phone (949)644-3288 v. Inspection Requests Phone (949)644-3255 �''�rr�ou�`°` Combination Type - MFP PLUM Issued Date : 05106/2021 Inspection Area : 2 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 05/06/2024 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: 200 ONYX AVE NB Description: MFR -CHANGE OUT WATER HEATERIDRYWALL RPR (STOP WORK) Legal Desc.: BALBOA ISLAND SEC 4 BILK 12 LOT 1 .� Owner: MARTIN DONNA Contractor: OWNER/BLDR Architect: Address: 1221 W COAST HWY, #410 Address: MARTIN DONNA Address: NEWPORT BEACH CA 92663.. Phone: 949/791-8979 Phone: Phone: State Lic: Applicant: MARTIN DONNA Con State Lic: O/B Engineer: Address: 1221 W COAST HWY, #410 Lic Expire: Address: CA Seismic Safety: NEWPORT BEACH CA 92663 Bus Lic: $0.00 Phone: 9491791-8979 Lic Exp Date: Phone: State Lic: Code Edit : Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Flood Zone: 2019 Worker's Compensation Insurance VB Carrier: R3/U Policy No: 0 Expire: 0 Building Setbacks Rear: / Front: / Left: I Right: / Building Permit Fee: $110.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $110.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $230.90 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Doom No,Phone: ,� m m o 00 m Special CLdNn ATUJrjDAyS Excise Tax: $0.00 Planning Department - Fire Inspection: Additional Fee : $0.00 Plan check Fee Demolition Fee Grading Bonds Fee: $0.00 Fair Share: General Service Grading PC Consultant: $0.00 SJH Trans : Grading Bond: Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $0.00 Public Works Department - WQ Insp. Fee: $0.00 Park Dedication : $0.00 PAN Plan Check: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing,/o: $9.90 Plan Check Fee : 0o m $0.00-0 $Q,00 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $230.90 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: ° o 60000C ° m Douce. Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: 0o m $0.00-0 $Q,00 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $230.90 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: ° o 60000C ° m Douce. r.,.. 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). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, 'usiness 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 n 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 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: y my signature below I acknowledge that, except for my personal resid nce in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall, all a structure that I have built as an owner -builder if it has not been on tructed 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 t pplication i mitted or at the foljSb sp7M:71—�.leginfo.ca.gov/calaw.html. ignature of Property Owner or Authorized Agent 1ti ✓%.� ✓� /� .0 Date Z .ICENSED CONTRACTOR'S DECLARA N 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 nd effect. License Class _. _ License No Date Contractor Signature COMPENSATION DECLARATION IARNING: 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 :OST OF COMPEN"TSO.N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm•lyVg� penalty of perjury one of the following declarations: 31 *4ve and.»ill 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 the erf ormance of tAq W6rk for which this permit is issued. Policy No. 34 knave 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 isukance ca nerarxi policy number are: Fvddr .... Polm, Numhar Expiration Date of Agent - - - Phone # rtify that, Otte 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ure of.LlAcant _ Date_ bEreby affitr; d r 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. I agree to comply with all applicable city and county or na ces and state laws relating to building construction. I authorize representatives of this city or county to e t above-ide I dd rope t fo—r, -inspection purposes. , �, / :Innnhrre of Prnnr:rry Owner or Authorized Anent/ LLe— ' V I/d.�, R l or Print Propertv Owner's or Authorized Agent's Name ��NYU I� rf'/ '//LDate ACTION DATE 01/ DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMIT EXTENDED QMD PERMITFINAL BESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF / POEITO ON OCCUPANCY ISSUED / � �fj � SIGNATURE: