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Home My WebLink AboutX2018-3845 - Permits� 1°fir City of Newport Beach - Buildipg Division 11IIIIII1II1IIIIIIIIIIIIIIIIIIIIIIIIIIIIII1IIIIIIIIIiiel, COMB Permit: X2O18-3845 o� 100 Civic Center Drive, Newport Beach, CA 92660 x 2 0 1 8 3 a 4 e Project No : 2967-2018 Permit Counter Phone (949)644-3288 v. .@ Inspection Requests Phone (949)644-3255 Issued Date: 01I09I2019 Combination Type - MFP ELEC PLUM Inspection Area : 8 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 an Sundays or Holidays Job Address: 20 HILLSDALE DR NB Description: MFR INSTL ELEVATOR 121 SF, NEW LIGHTING @ 1ST FL, PEX-RE-PIPE Legal Desc.: TR 11785 LOT 1 UNIT 14 OF PROJECT LOCATED ON AP 442-301.69 TOGETHER Owner: BALBONI PAUL Contractor: A M S BUILDERS Address: 20 HILLSDALE DR Address: 18171 BIGLOW PARK NEWPORT BEACH,CA 92660 TUSTIN CA 92780 Phone: Phone: 714-492-2471 Applicant: TABAR MEHRDAD Con State Lic: 925177 Address: 14252 CULVER DR #349 Lic Expire: 11130/2020 IRVINE CA 92604 Bus Lic: BT30065262 Phone: 714-725-0017 Lic Exp Date: 12131/2019 Code Edit : 2016 Type of Construction: V-B Occupancy Group: R2 Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: $50 000.00 Building Permit Fee: $746.00 Plan Check Fee: $649.02 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $14.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $2.00 TOTAL FEE: $1,570.38 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: EXEMPT Policy No: Expire: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: I Front: I Left: I Right: I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $52.22 $0.00 $67.14 Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: State Lic: TABAR MEHRDAD 14252 CULVER DR #349 IRVINE CA 92604 714-725-0017 State Lic:C-037433 Special Conditions: Fire Hazard Zone : N Planning Department - Plan check Fee: Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PM Plan Check.: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $40.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: S;O^ $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $689.02 Fee Due at Permit Issuance : $881.36 PUBLIC WORKS APPROVAL: PLAN CHECK BY: �- APPROVAL TO ISSUE: i, 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 thr 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 pJnalty 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 U 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:hftp://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 70Q) of 'via3 of the Business an4 Profess! a e, d m licel a is i full force and effect. License Class License No pate/ Contractor Sig lure > WORKERS' COMPENSATION DECLARATION WARNING: FAILURE' ro SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby iffirm unrer o=nalty of perjury one of the following declarations: P. 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, p,Qrfonnance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number of Agent _ Date ertii/ that, in r;he 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 if I should become subject to the workers' compensation provision§ of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / ne!u,e of kplicart _ K' /l.! t./ CXa CLARATION REGARDING CONSTRUCTION LENDING AGENCY :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 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 rdinances and state I a r ing construction. I authorize representatives of this city or county ter e a e--' nti prop y inspection purposes. nature of Property Owner or Authorized -Agent Print Property Owner's or Authorized Agen('9�Ja�ne> ACTION DATF(a BY I RDECLARATION I EGULATIONS OF COMPLIANCE 40 WITH CODE OFD AQMD FEDE ERAL I FOR OFFICE USE ONLY PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED OEPA PERMIT EXTENDED qM D PERMIT FINAL 2., f D 2 D A ESTOS NOTIFIrCA ION IS NO CABLE TO CERTIFICATE OF p ? SED DEMf�LIl�O� OCCUPANCYISSUED N TUBE: I' ��(( Ci —11 Civil Code). r-g