HomeMy WebLinkAboutX2017-2925 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII II COMB Permit: X2017-2925
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 2 9 2 5 Project No: 2042-2017
Permit Counter Phone (949)644-3288
v r Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC MECH Issued Date :
Inspection Arearea :2018
6
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
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: 23 STONE PINE NIB
Description: SFR - REMODEL KITCHEN, FMLY RM & MASTER BDRM 600 SF -- ---
Legal Desc.: _
Owner: JENNINGS CYNTHIA
Contractor:
Z S W INC
Architect:
AZIZI MASUM M
Address: 10795 WILSHIRE BLVD #504
Address:
P O BOX 693
Address:
4701 VON KARMAN AVE #156
LOS ANGELES CA 90024
DANA POINT CA 92629
NEWPORT BEACH CA 92660
Phone: 818-681-7722
Phone:
949-370-8391
Phone:
949-669-7999 State Lic:CO24129
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Applicant: AZIZI MASUM M
Con State Lic: 846269
Engineer:
FARHAD MANSHADI
Address: 4701 VON KARMAN AVE #156
Lic Expire:
0 913 012 01 8
Address:
1800 E. 16TH ST'"~'�'®
NEWPORT BEACH CA 92660
Bus Lic:
BT30045965
SANTA ANA CA 92701
Phone: 949-689-7999
Lic Exp Date:
0113112018
Phone:
714-835-2800 State Lic:EOGIOEER
r
Code Edit : 2016
Worker's Compensation Insurance
Designer:^^=T^-.�1
Type of Construction: VB
Carrier:
STATE COMP.
INS Address:
�.
Occupancy Group: R31U
Policy No:
1741290
cl ,z.,
Added /New sq.ft. Bldg: 600
Expire:
05108/2018
Phone:
` `' =" "7.
Added /New sq. ft. Garage: 0
a`�,
No of Stories: 2
Building Setbacks
Rear: I
Special Conditions: VHSFZ & LANDSLIDE
No of Units : 1
Front: I
AREA
Bldg Height: 0
Left: I
Bldg Sprinklers: N
Right: I
Flood Zone: X
Use Zone:
Parking Spaces:
0 Fire Hazard Zone : Y
Construction Valuation: $60.000.00
Building Permit Fee: $786.00 `
Excise Tax:
$0.00
Planning Department-
Fire Department
Plan Check Fee: $683.82
Additional Fee :
$0.00
Plan check Fee:
$37.50 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00
Fair Share : -
$0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant:
$0.00
SJH Trans :
$0.00 Demolition Fee
Record Management: $34.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00 Building Dept Adm
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety: $0.00
WQ Insp. Fee :
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
Disabled Access : $0.00
PAN Plan Check: $0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical W
$55.02
San Dist: $0.00
Building Green Fee : $3.00
Mechanical %:
$31.44
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $1,630.78
Plan Check Fee:
$72,1.32 ... Fee Due at Permit Issuance : $909.46
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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
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
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
improved 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).
❑ 1 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 legally
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of IVT D9 of the Business and Profe to ode, and my license is in full force
and effect. License Class License No Date ! S 17 Contractor Signature
NORKERS' 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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,
)erl.0"ance of tpe work for which this permit is issued. Policy No.
have and wi m tarn 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'
rance carrier And dlolicv numbemna: , -
Number
Of
Date
certify that; In the perfor ft c for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation la /s of California, and ogre
if I should become s. o e ork fs' o pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. d
lture of Applica f v
LARATION REGARDIIIIIb COINITTRUCTION LENDING AGENCY If
)reby 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).
lder's Name Lender's Address
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 o
as and state laws relating to building construction. �
I authorize representatives of this city or county t r e identified property for inspection purposes. / n�
nature of ProDertv Owner or Authorized Aaent Print Pronertv Owner's or Authorized Aaent's Name ll ✓'/
ACTION
DATE
BY ( DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY -
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
U I SUBMITTED ASBESTOS+NO•TIFI('QTION 7O • • s
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PERMIT CANCELLED
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PERMIT EXTENDED
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SBESTOS NO C IS TAPPLICABLE TO
CERTIFICATE OF
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PROPOSED DEITI •'• ••
OCCUPANCYISSUED
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SIGNATURE: • : • • • • •••
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