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Home My WebLink AboutX2020-0203 - Permitsc*�ro City of Newport Beach - Building Division Contractor: 100 Civic Center Drive, Newport Beach, CA 92660 Architect: Permit Counter Phone (949)644-3288 ' Inspection Requests Phone (949)644-3255 196 TECHNOLOGY DR #J Combination Type - BLDG COMB Permit: X2020-0203 Project No : 1261-2019 Issued Date: 0112312020 Inspection Area : 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: 11 SARTEANO DR NB Description: SFR*CHANGE OF CONTRACTOR* RETAINING WALL 4'X 43 LF (INSIDE P/L) Legal Desc.: Owner: SABOUNJIAN AZAD/SUSAN Contractor: WYSS GROUP Architect: Address: 11 SARTEANO DR Address: 196 TECHNOLOGY DR #J Address: Planning Department - NEWPORT COAST CA 92657 Plan Check Fee: $0.00 IRVINE CA 92618 Additional Fee : Phone: Plan check Fee: Phone: 949.325-5515 Phone: Applicant: SHAUNA/RAHMAN MOKSUDUR Con State Lie: 1015500 Engineer: Address: 14616 MCKENDREE AVE Lie Expire: 06/30/2020 Address: Record Management : CHINO CA 91708 Bus Lie: BT30059571 In -lieu Housing Fee Phone: 213400-8078 Lie Exp Date: 06/30/2020 Phone: Code Edit : 2016 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9209391 Expire: 04/27/2020 Building Setbacks Rear: 0 Excise Tax: Front: 07-20 Planning Department - Left: 0 Plan Check Fee: $0.00 Right: 0 Designer: Address: Phone: State Lie: RAHMAN MOKSUOUR 14616 MCKENDREE AVE CHINO CA 91708 213-400-8078 State Lic:C-069263 Special Conditions: VHFHSZ REPLACE X2019-1754 Construction Valuation: 90.00 $0.00 Fire Inspection: $0.00 Fire Plan Rev Building Permit Fee: $0.00 Excise Tax: $0.00 Planning Department - General Service Plan Check Fee: $0.00 Refund Deposit Additional Fee : $35.00 Plan check Fee: Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans Record Management : $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Disabled Access : $0.00 PAN Plan Check: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE : $35.00 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 : $0.00 Fee Due at Permit Issuance : $35.00 6 • • •P[I41iV ORKS APPROVAL: c c `• m•c ocu oo �e,c m v PLAN CHECK BY �FrF�R10V4L TO ISSUE a 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: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $35.00 6 • • •P[I41iV ORKS APPROVAL: c c `• m•c ocu oo �e,c m v PLAN CHECK BY �FrF�R10V4L TO ISSUE a 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 1 f Division 3 of the Business and Pr ss s Cc my license is in full force and effect. License Class License No Da 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 ($100,00D(, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ❑JJ,, 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 the )e4rmance 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' compensation rance carrier .p* Iicy number r _ ier Soli ber Expiration Date 1e of Agent 1 Phone # certify that, in the performance of the vwpp for which this j1armit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrec if I should become subject to the /q�pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. a / lature of Applicant X / DaWS'e j(z'3 /2,62,0 3reby 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). ider'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 ordinance tate laws relating to building construction. I authorize representatives of this city or count enter th tified property for inspection purposes. `_iCU ��(� nature of Pronertv Owner or Authorized ADent Print Procertv Owner's or Authorized AGent's Name\,c 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 LJ I SUBMITTED ASBESTOS NOTIF16ATION TO •• PERMITC4NCELLED DEPA • • • • • • PERMIT EXTENDED QMD PERMIT FINAL " ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF rr 7FROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: • • _• • • •. ' __ _