HomeMy WebLinkAboutX2022-0713 - PermitsCity of Newport Beach - Building Division
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A 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - SFP
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PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID
PEEL . R
Construction Hours: Monday- Friday 7:00 a.m. to 6:3
.m. a
aturd
Job Address:
104 ONYX AVE NB
n1
Description:
SFR NEW DECK 207 SF, TEAR -OFF (E) ROOF, INSTALL MET OOFING
MCELRRY
Ic
Legal Desc.:
BALBOA ISLAND SEC 4 LOT 1 BILK 1 NLY 35 FT
O
Owner: GRUMET THERESA
Address: PO BOX 10B
NEWPORT BEACH CA 92662
Phone
Applicant:
SMITH EVERETT
Address:
3437 PONMAC CT
PERRIS CA 92570
Phone:
951-323-2187
Code Edit:
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units : I Bldg Height:
Bldg Sprinklers:
Flood Zone:
Valuation:
2019
VB
R3/U
GRUMMET HARRi
O/B FORM ATTACHED
805 722 2222
XicacareccO/BExpire.Lic
Exp Date:�yd''t'
Worker's Compensation Insurance
Carrier.
COMB Permit: Xs'
d Project No : 0630-2022
Issued Date : 06/02/2022
Inspection Area : 2
MUS oOMPLETED
p.m 8Y OR PERMIT WILL BE INVALID
8:00 m. to 6:00 p.m. No rk on Sundays or Holidays
18 SQUARES.
Architect:
Address:
oiIiPhone: State
4Engineer:'., 0i AN MOKSL
Address:
146 6 MCKENDREE E
CHftf�'(7 CA a
Phone 213-400-8078 L't�
o ! Desi9nt=rs'S, .-
Acura-
Expire `r" ,Qprcne:
0 Building Setbacks' Re 10
10 Front: 5
Left. 3
Right 3�
Building Permit Fee: $559.00
Plan Check Fee: $486.33
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$30.00
Energy Compliance:
$0.00
CA Seismic Safety:
$3.90
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$2.00
TOTAL FEE: $1,183.98
PROCESSED BY:
ZONING APPROVAL:
E x: $0.0
Fee: o
Bonds Fee:
`ing PC Co to t:.J
Grading Permit 0.
Grading P e: . 0
Q 1 0.00
Ele ical 00
Mech ical %: $0.00
Plumbi %: Qj• $0
Specie ondi
// air Si.
�QV SJH T ns
In u - sing Fee:
P is orksDepartment-
P, Dedication : $0.00
NV Plan Check : $50.75
San Dist: $0.00
NMUSD Fee: $0.00
L EFAC &HIGH
ENSITY AREA
N
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:
101
I heck Fee : $538.33 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
�U
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$645.65
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) ind,i�% d.,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 mclish, 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 Li nse Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violati 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 ) portions of the 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 pr rty who, through eyees' 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 in oneyear of coRlple ion, the Owrfer-Builder will have the burden of proving that it was not built or
Fimprr ved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to constr the pr(Se ctiQla
apply to an owner of p,00erty who builds or improves thereon, and who contracts for the p cis wit ' .' a setr
El I am, exempt from icensure under the Contractors' State License Law for the folio g reaso C`
By my signaturebe,o� I acknowledge that, except for my personal residence in whi I must resided r at least
sell a structure t,hat I h2ve built as an owner -builder if it has not been construc e . ` its i — contragKcs
Professirns Code, Is available upon request when this application is subm e- r at 11 w' site:htttp
Slgnawre of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION X,T x{J
4, Busin s and Professions Code: The Contractors' State License Law does not
for Pur9fiant to the Contractors'. State License Law).
!(year prior to completion of the improvements covered by this permit, I cannot legal
understand that a copy of the applicable law, Section 7044 of t e Bus ess and
prifo. ca.gov/calaw.html. �
Date
e.
I Aerej, affirm under penalty of perjury that I am licensed under pro Ions of Ch ter 9 (commencing, with Section 7000) of Division 3 of the BusindE
an'i s`f^ct. License Dlcss Lic a No Date Contracto'
WORKERS' COMPENSATION DECLARATION
w A.J.I:IC: -AILURE TO SECURE WORKERS' COMPENSATION COVE E IS UNLAWF , AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
COS, OF LOMPENSiA110N; OHMAGES AS PROVIDED FOR IN SECTI 3706 OF THE BOBACODE, INTEREST, AND ATTORNETS FEES --1
I hereby affirm under peilalty of perjury one of the f wing decl tions:
0. I- F.ave and 011 cair:tain a certificate of sent to se nsure: for workers' compensation, issued by the Director of Industrial Relations as prc
performance of the work for which this per . IS iSSUWi. licy No.
have and will maintain workers'
rance carrier and policy numbe`
rNle of Agentcertify that, in the pe moot! if should become su ct t0ature of Applicant
required by Section3700. of the Labor Code, for the performance of the
Number
it is
Teby affirm under penalty of pert that W s a tioi�
Ider's Name
my signature below, I certify to each the foil, rii'n.
I am the property owner or authorized act 0 ow
I have read this application and the=infor tion I v, vided
I agree to comply with all applicable city an aunt inances
I authorize representatives of this city or'coun to enter the
nature of Property Owner or Authorized Agent
TION DATE BY I XCLARANI
PERMITEXPIRED
UISUBTqLT
PERMITCANCELLED
EPA
PERMIT EXTENDED
0AQMC
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DIA&BESTO
PROPOSED C
SIGNATURE:
is
and my license is in full force
16100,0001, IN ADDITION TO THE
for bI 3700 of the Labor Code, for
is issued. My workers'
d I shall not employ any person in any manner so as to ecome j to the workers' compensation laws o72—
agency alifornia, and agre
;ph3700 of the Labor Code, I shall forthwith co y with t se ovisio is. ,�( /�'
Date/ � `� 1 �' for therperto nce of a work fo hich th' pei is issued (Section 3097, Civil Code).
oArty^ner's or Authorized Agent's Name
7L FOR OFFICE USE ONLY
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