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Home My WebLink AboutX2022-1387 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-1387 T 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 1 3 8 7 Project No : 2036-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date : 05/1612022 Combination Type - MFP Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVALID 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: 438 GOLDENROD AVE NB Description: MFR -'FRONT UNIT* - T/O COMP SHINGLES. INSTALL 30# FELT. RPLC DAMAGED WOOD AS NEEDED. INSTALL 12 SO COMP SHINGLES Legal Desc.: CORONA DEL MAR BLK 434 LOT 22 Owner: MEDALI REZA Address: 3136 E ABBEY LN ORANGE, CA 92867 Phone: 626-485-8277 Applicant: HAJIALI AH MAD Address: 701 S RAYMOND AVE #1 FULLERTON, CA 92841 Phone: 949-637-2271 Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: I No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Contractor: CAL - STATE ROOFING Architect: Address: 702 MONROE WAY Address: PLACENTIA CA 92870 Phone. 714-813-7736 Phone: Con State Lic: 801616 Engineer: Lic Expire: 11/30/2023 Address: Bus Lic: BT30075986 Lic Exp Date: 0713112022 Phone: Worker's Compensation Insurance Designer: Carrier: CLEAR SPRING PROP & CASUALTY C Policy No: Expire: Building Setbacks Use Zone: CWC00616800 0312312023 Rear: / Front: / Left: / Right: / Fire Construction Valuation: $4 000.00 Building Permit Fee: $351.00 Excise Tax: $0.00 Planning Department - Plan Check Fee: $0.00 Additional Fee : $0.00 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 $0.00 In -lieu Housing Fee Public Works Department - Energy Compliance: $0.00 Grading PC Fee: $0.00 l Park cation $0.00 CA Seismic Safety: $0.00 WO Insp. Fee: PA; Plan Check : $0.00 Disabled Access : $0.00 $0.00 Electrical %: $0.00 San Dist : $0.00 Hazardous Mat Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 TOTAL FEE: $352.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Conditions�'`� State State Lic: Fire Depa li $0.00 Fire Ins $0.00 $0.00 Fire Plan $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee : $0.GG Fei Due at oermit Issuance : $352.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL. TO 19SUE: 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 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 (_) 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 mproved 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 legall, 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 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) 1 is' n 3, the Business and P f d my erfEeli�f �Or and effect. License Class License No [ ontractor Signatur( (�� // I NORKERS' COMPENSATION DECLARATION VARNING: 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 1$100,000I, IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 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 serf rmance 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 JI certify that, in the performance of the work for which this permit is issuqb, I shall not employ any person in any manner so as to become subject to the workers' compen tion law of California, and agre tat, if I should become subject to the IItw1oorrlkers' compensation o Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /� ignature of Applicant ,,, (y r )V1 L,/7 �Cf.J� D DECLARATION REGARDING 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 (Section 3097, Civil Code). ender's Name Lender's Address y 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 above -identified property for inspection purposes. ignature of Property Owner or Authorized Agen� int Property Owner's or Authorized Agents Nam v '/Y / Date ACTION PERMIT EXPI RED PERMITCANCELLED PERMITEXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE D ASBESTOS NOTIPCATION TO ASBESTOS NOTIFICATION IS NOT APPLICABLE TO