HomeMy WebLinkAboutF2021-0375 - Permits�Nww.{n0T City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 6 NIGHT SKY NB
Inspector Area: FIRE
Owner:
MIRRAFATI SAYED
Address:
6 NIGHT SKY
NEWPORT COAST CA 92657
Phone:
949-677.1698
Applicant:
KHAMENEYAN MOHAMMAD
Address:
28031 CASCABEL
MISSION VIEJO CA 92692
Phone:
949-310-7324
Code Edit : 2019
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
Flood Zone:
Bldg Sprinklers: N
*F2021-0375*
� 6^+-'S" r-+
FIRE Permit: F2021-0375
Project No : 0526-2021
Inspection Requests Phone (949)644-3255
Description: FUEL MODIFICATION (X2021-0570) "CHANGE OF CONTRACTOR -
Legal Description:
Contractor: 0 W NER/BLDR
Address:
Phone:
Con State Lic: OIS
Lic Expire:
Bus Lic:
Lic Exp Date:
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Issued Date: 08/25/2021
Setback- Front:
Rear:
Left:
Right:
Architect
Address:
Phone: State Lid
Engineer:
MEHDIZADEHNASRABADI MOHAMMA6 '
Address:
145 COTTONWOOD
IRVINE, CA 92618
Phone:
949-554-7900 State Lic: C-085373 ,
Designer:
Address:
Phone
Special Conditions:
FEES
Construction Valuation:
$0.00
Building PC Fee :
$0.00
Fire Residential Alarm PC Fee :
$0.00 Records Management :
$0.00
Building Overtime PC Fee:
$0.00
Planning Counter Review,
$0.00
Building Extention Fee :
$0.00
Planning Zoning PC Fee :
$0.00
Building Investigation Fee:
$0.00
$0.00
Fire Plan Check Fee:
$0.00
Public Works PC Fee :
$0.00
$0.00
Fire Permit Fee :
$0.00
Public Works Traffic Plan Check Fee;
$0.00
Building Permit Fee :
$0.00
TOTAL FEE :
$38.00
Plan Check Fee :
$0.00 Fee Due at Permit Issuance :
$38.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL:
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
DWNER-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 checture, prior to its issuance, also requires the applicant for
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, prio
: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
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
iot more than five hundred dollars ($500).
I, as nwre- of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Sectionprovided that the
Busines[ and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property,
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
�mi ved for the purpose of sale).
s 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
' hly to an wner 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 f,om licensure under the Contractors' State License Law for the following reason:
Bymy 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
,LII a struc:Lrr. tha+ 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, Sect 044 p�f/tthe Business and
rrcfessionr CoCE, is available upon request whe t I applicati s submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. D / 2
Signature of Property Owner or Authorized Agen
LIr'FNSED COh"RACTOR'S DECLARAT
hereby aff im iinde- penalty of perjury that I a er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect.
Licenoe Class — License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: 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 ($100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND AT'rORNEY'S FEES. .
I hereby affirm under penalty of perjury one of the following declarations:
I 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
—formance of the work for which this permit is issued. Policy No. ..
I 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'
urance carrier and policy number are:
Policy Number Expiration Date
me of Agent- --
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
t, if I should become subject to the workers' compensation provisions t -3700 of the Labor Code, I shall forthwith comply with those,p ovisions. .1 �%� // �-
nl py X/1 I N / ✓ /
nature of Applicant
CLARATION R R CTION LENDING AGENCY
ereby affirm under y of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil
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 ordinances and state laws relating to building construction.
I authorize representatives of this city or count Ke=fied property for inspection purposes. 1 /
(nature of Prooerty Owner or Authorized Agent pe y Owners or Authorized Agents Name J
ACTION I DATE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
BY FEDERAL REGULATIONS PART 61 OF TITL.E40 AND
AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS N077FICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIHCA77ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
a;/V,4