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Home My WebLink AboutX2021-1830 - Permits.1 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 'dxrraxa'r Combination Type - SFP IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII0 II COMB Permit: X2021-1830 Project No : Issued Date : 07/13/2021 Inspection Area: 0/ PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0711312024 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: 411 POPPY AVE NB Description: SFR 30 LB PAPER & PRESIDENTIAL SHINGLE OVER ONE LAYER OF 30 YR COMP 16 SQ CLASS A Legal Desc.: CORONA DEL MAR BLK 443 LOT 9 Owner: TOBEY DON & DONNA Contractor: OWNER/BLDR Architect: Address: PO BOX 765 Address: TOBEY DONNA Address: CORONA DEL MAR, CA 92625 0/B AUTH ATT Phone: 657-203-9222 Phone: 657-203-9222 Phone: State Lic: Applicant: TOBEY DON & DONNA Con State Lic: O/B Engineer: Address: PO BOX 765 Lic Expire: Address: CORONA DEL MAR, CA 92625 Bus Lic: Phone: 657-203-9222 Lic Exp Date: Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: V -B Carrier: Address: Occupancy Group: R3/U Policy No: Added /New sq.ft. Bldg: 0 Expire: Phone: Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $13.500.00 Building Permit Fee: $351.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee : $0.00 Fire Inspection: Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev 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 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department- General Service CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit Disabled Access : $0.00 P/W Plan Check : $0.00 Grading Bond: Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE: $352.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $352.00 Fee Due at Permit Issuance : $0.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: 000000 o m u oom000 0 0 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 §ofessions 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 iot 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness 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 rovemenIS 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 r ved for the purpose of sale). 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). 1 am exempt from licensure under the Contractors' State License Law for the following reason: 3y 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 legalh all 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 Irofessions Code, is, available upon request when this applicati sub d or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Z / Date / % 3ignature of Property Owner or Authorized Agent -/r _ICENSED CONTRACTOR'S DECLARATI6N hereby affirm urr'der 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 .%d (�*ct. Lipenw class License No Date Contractor Signature NORKERS'bdMPENSATION DECLARATION IAeNMrp: FAILURE TA SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,000), IN ADDITION TO THE :OSW eF COMPEN SATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herebq affirm uneePpenalty of perjury one of the following declarations: 7NAave 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 iertortnance o:tDg riplk for which this permit is issued. Policy No. 3FAave 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 'I%§WiQe carrier and.policy number are: ;arrier' • • • • Policy Number Expiration Date JAhehtAgent Phone # :1••• .•. I 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 ogre hat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3ignature of Applicant Date )ECLARATION REGARDING 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 3y 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 th v - 1 ied property for inspection purposes.�� [ 3ignature of Property Owner or Authorized Agent M Print Property Owners or Authorized Agent's Name & r11' L L) b pt ACTION DATE BY DEC ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RE LATIONS PART 61 OFTITLE 40 AND AQMD R6LtE PERMIT EXPIRED PERMITCANCELLED "�� NOTIFICATION ISSN PLICAS CERTIFICATE OF P POOSEDED DEMOLITION OCCUPANCYISSUED SIG