HomeMy WebLinkAboutX2018-2792 - Permitsg 1p
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
Combination Type - SFP
COMB Permit: X2018-2792
IIIIXI�IIIIIIIIIIIIIIIII�II�I�IIIIIIIII�IIIIIIIIII II
Project No : 2230-2018
Issued Date : 09/18/2018
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: 18 VIA AMBRA NB
Description: SFR REMOVE SOFFITS 8 TWO BEARING INTERIOR COLOMNS @ THE FAMILY ROOM (80 SF) -
Legal Desc.:
Owner: MASOUD BOKAIE
Contractor:
OWNER/BLDR Architect:
I • v ��%f f u.
Address: 18 VIA AMBRA
Address:
MASOUD BOKAIE Address:
NEWPORT COAST CA 92657
Phone: 949-302-8092 '
Phone:
Phone:
State Lic:
Applicant: MASOUD BOKAIE
Con State Lic:
Cie
Engineer:
BOKAIE MASOUD
Address: 18 VIA AMBRA
Lic Expire:
Address:
2211 MICHELSON DRIVE 450
NEWPORT COAST CA 92657
Bus Lic:
IRVINE, CA 92612
Phone: 949-302.8092
Lic Exp Date:
Phone:
949/261-4852 State Lic:S-002751 •...
Code Edit : 2016
Workers Compensation Insurance
Designer:
® o
Type of Construction: VB
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: 018 AUTH ATTACHED
o ° ° ° ° ° ° ° • °„
No of Units : 1
Front: I
• • „
Bldg Height: 0
Left: /
oOOc°o omo.,
Bldg Sprinklers:
Right: I
Flood Zone:
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
° ° • °, ° „
Construction Valuation: $15,000.00
... • ° ° o
0
Building Permit Fee: $292.00
Excise Tax:
$0.00
Planning Department -
Fire Department
00000,
. • o 0
Plan Check Fee: $254.04
Additional Fee:
$0.00
Plan check Fee :
$37.50 Fire Inspection:
• • o000
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 : $16.00
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 %:
$0.00
San Dist: $0.00
Building Green Fee : $1.00 -
Mechanical %:
$0.00
NMUSD Fee: $0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE : $600.54
Plan Check Fee:
$0.00 Fee
Due at Permit Issuance :
$600.54
PROCESSED BY:
PUBLIC WORKS APPROVAL:
ZONING APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL:
APPROVAL TO ISSUE:
y
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 itevm(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
Drofessions 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
lot 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,
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
ooed f epurpose of sale). _
owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The ContractorsState License Law does not
ly 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 forihe 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 co red by this permit, I cannot legally
sell a structure that I have built as an owner -builder if it h snot been constructe its entirety by licensed contractors. I understand that a copy of the applicable law, Secti n 7044 of the Business and
Professions Code, is available upon request this ap is n is s ed or at a following Web site:http://www.leginfo.ca.gov/calaw.html. I bgl ?O Ig
Signature of Property Owner or Authorized gent a
LICENSED CONTRACTOR'S DEC LA TIO
I hereby affirm under penalty of perjury that I am licens d under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professio s ode, and my license is in full force
and effect. License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURrsTp.FECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUB.IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000), IN ADDITION TO THE
COST OPCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirmanderp* nalty of perjury one of the following declarations:
at lave 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 thi
perfaftance of tre wojk for which this permit is issued. Policy No.
OL haue and wllll 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' compensatior
insula'nce carrier aric6policy number are:
L'acriier. • • Policy Number Expiration Date
of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the
he workers' compete provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ECLARATION411MARDING 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
ender's Name Lender's Address
Iy my signature below, I certify to each of the following:
I am the property owner or authorized to act on the roperty owner's behalf.
I have read this application and the information I h e provided is correct.
I agree to comply with all applicable city and count ordinances and state laws relating to building construction.
I authorize representative this city or county to nter the abov = led pr y for inspection purposes.
_...____�...,... Print Pronertv Owners or Authoriz DenVs Nam
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
DATE BV DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
DA-�
I SUBMITTED ASBESTOS
TO
IS NOTAPPLICABLE TO
compensation laws of California, and agree
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