HomeMy WebLinkAboutXR2023-1306 - PermitsaeWPo City of Newport Beach IIIIIII�II�IIIIIIIIIIIIIIIIII II COMB Permit : XR2023-1306
Community Development Department -Building Division X R 2 0 2 3 1 3 0 6
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-1175
Permit Counter Phone: (949) 718-188B Issued Date : 05/24/2023
u newportbeachca.gov/civic Inspection Area : 6
Combination Type - SFP ELEC MECH PLUM
Work Class - Alteration
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 14 ANDIAMO Legal Desc : N TR 15337 BILK LOT 42
Description: SFR ALT REPLACE INT WALL WITH BEAM BETWEEN KITCHEN/DINING ROOM. REMODEL KITCHEN AND PEX REPIPE. REPAIR SECTION OF STUCCO AT
SIDE 950 SF (STOPWORK 123-1518)
Owner: BOROUKHIM SILVANA TR
Address : 14 ANDIAMO
NEWPORT COAST, CA 92657
Phone : (714) 915-7272
Applicant: MOMO DESIGN GROUP INC
Address : 30 EDELMAN
IRVINE, CA 92618
Phone: (949)874-2433
Owner/Builder :
Address :
Contractor: MOMO DESIGN GROUP INC
Address : 30 EDELMAN
IRVINE, CA 92618
Phone : (949) 874-2433
Con State Lie:
1037903
Lie Expire :
04/30/2024
Bus Lie:
BT30081557
Bus Lie Expire :
05/31/2024
Workers' Compensation Insurance
Carrier: STATE FUND
Policy No: 9308660
W. C. Expire : 11/12/2023
Architect
Address
Phone:
State Lie
Engineer: SHAYAANHABIBI
Address : 10535 WILSHIRE BLVD, 1602
LOS ANGELES, CA 90024
Phone : (310) 562-1717
Designer
Address
Phone:
Phone:
Code Edition :
2022
Fire Sprinklers : NO
Construction Valuation
Type of Construction :
V-B
Fire Hazard Zone : YES
Added/New/Ti sq. ft. Bldg
Occupancy Groups :
U,R-3
No of Units : 1
Alteration sq. ft. Bldg:
Bldg Height :
No of Stories : 1
Added/New sq. ft. Garage:
TOTAL sq. ft.
Building Setbacks :
Front: 10, Side: 5, Side: 5, Rear: 10
Flood Zone :
X
Use Zone :
PC - Newport Ridge
PROCESSED BY:
SPECIAL CONDITIONS:
°-
<- °
$40,000.00
0
0
0
.BUI
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items)
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
to 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
'rofessions Code,) or that he or she is exempt from licensors and the basis for the alleged exemption. Any vida€ron of Section 7031.8 by any applicant for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
1 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale. (Section 7044,
rosiness and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
nprovemants 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
ntproved for the purpose of sale).
.J 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
ly to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
J I am exempt from licensors under the Contractors' State License Law for the following reason!
ty 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 legal
oil astructure that I have built as an owner builder if It has not bean constructed in its entirety by licensed contractors. I understand that a copy of theapplicable law. Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:Uwww.leginfo.ca.govlcelaw_htmi,
signature of Property Owner or Authorized Agent Date
ACENSED CONTRACTOR'S DECLARATION
hereby affirm under Dandify of pertury that I am licensed under provisions of Chapter 9 (commencing with Section of Diw ig n etof the Business and Prof sic /hod , L I' e' in btl iofaa
nd affect. License Class License No Dat /ALL/ % S COritractar Sionatum �A
VORKERS' COMPENSATION DECLARATION I 1i if�
1ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UPTOONE HUNDRED TH USANO DOLLARS ($100,000). IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 770E OF THE LABOR GODS, INTEREST, AND ATTORNE 'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I I have and *it maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided tot by Section 3700 of the Labor Code, for th
kmance of the work for which this permit is issued. Policy No.
ave and will maintain workers' compensation Insurance, as required by Section 3700 of thee. Labor Code, for the performance of the work for which this permit is issued. My workers` compensatiol
tsura ce carrier and policy number are:
:arrier Policy Number Expiration date
lame of Agent Phone #
11 certify that. in the performance of the work for Vhich this p amt is issued. !shall net. employ any persona any manner so as to become subject to the works Dompensation 9- ws afCslifamia, and ogre
tat, 9f I should become bjact t we s' c pe n rnvtsions OfSectiorr 3700 of the Labor Code, I shalt forthwith comply with those provisions.
ignature ofAppli D Z __-__�_____
IBCLARATtON REGA d CO STRUCTION LENDIN�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 (Section 3097, vil Cade).
ender's Name Lender's Address
yy 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 1 have provided is correct.
I agree to comply with all applicable city and c hty o direness and tate I elating to building.. construction. AA j� `/J Mel
�� }�/� �i G
I authorize ores Owner
o A the City o6 coun�th f arty for inspection purposes. Y It/L V 45e*t IV 1 e I 1 I ""�7hara _/ .itlnaiure Of Pranerkv C]wneY or Authorized Arent Print Prnnanv C)vmrxr't Or AUtNnri,wri Anwrrt'R Na
ACTION I DATE I 6y 1 REGULATIONS PARTDECLARATION OF nPLIANCE WITH CODE OF 1 of TITLE 40 AND RULE At � FOR OFFICE USE ONLY
PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
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