HomeMy WebLinkAboutX2022-1388 - Permitssrt;� City of Newport Beach - Building Division IIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2022-1388
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 1 3 8 6 Project No : 2036-2021
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255 Issued Date : 05/16/2022
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 -'REAR UNIT" - TIO COMP SHINGLES & TORCH DOWN. INSTALL 30# FELT. RPLC DAMAGED WOOD AS NEEDED. INSTALLS SQ COMP SHINGLES, 4 SQ TORCH DOWN
Legal Desc.: CORONA DEL MAR BLK 434 LOT 22
Owner: MEDALI REZA
Contractor:
CAL - STATE ROOFING Architect:
Address: 3136 E ABBEY LN
Address:
702 MONROE WAY Address:
ORANGE, CA 92867
PLACENTIA CA 92870
Phone:
State Lic:
Phone: 626-485-8277
Phone:
714-813-7736
Applicant: HAJIALI AHMAD
Con State Lic:
801616
Engineer:
Address:
Address: 701 S RAYMOND AVE #1
Lic Expire:
11/3012023
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FULLERTON, CA 92841
Bus Lic:
BT30075986
07/31/2022
NQ'�7`
State Lic:
Phone: 949-637-2271
Lic Exp Date:
D.yu�noo
Code Edit : 2019
WorkersCarrier:
��'+J
Insur NG
j`�'�
PROP & CASUALTY C esigner: Address:
Type of Construction: V-B
Occupancy Group: R31U
Added /New sq.ft. Bldg: 0
Policy No:
Expire:
CWC00616800
03/23/2023
THE \N SEKEND
Added /New sq. ft. Garage: 0
Building Setbacks
Rear: /
ON
Special Conditions:
P
No of Stories: 2
Front: 1
No of Units : 1
0
Left: /
%'
Bldg Height:
Right: I
IN
Bldg Sprinklers:
Flood Zone:
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
tion Valuation: $4500.00
Permit Fee: $351.00
Excise Tax:
$0.00
Planning Department -
$0.00
Fire Department
Fire Inspection:
ck Fee: $0.00
Additional Fee :
$0.00
$0.00
Plan check Fee :
Fair Share : $0.00
Fire Plan Rev
Plan Ck: $0.00
FFInvestigation
Grading Bonds Fee:
Grading PC Consultant :
$0.00SJH
Trans : $0.00
Demolition Fee
tion Fee: $0.00
$0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee : $0.00
Building Dept Adm
anagement :
$0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
ompliance:
$0,011
WQ Insp. Fee :
$0.00
Dedican ation
ofund Deposit
mic, Safety :
Par
$0 00
G g Bond:
Disabled Access : $0.00
$0.00
Electrical W
$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
Plan Check Fee
: $C.09 Fee Due at Permit Issuance
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
PUBLIC "NORI S APPROVA'_:
PLAN CHECK BY:
APPRAVAL� Tl'1 1:3SUE:
o=CTR
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$352.00
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)
ction 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
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
fessions 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sale compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Iiness 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
rovements 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
roved 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
ply 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).
J I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 thi
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:l/www.leginfo.ca.gov/calaw.htmi.
ignature of Property Owner or Authorized Agent Date
ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divi f Business and Prof
Wi
and effect. License Class License No Date r ontractor Signaturd�/(•
VORKERS' COMPENSATION DECLARATION
IARNING: 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 ($100,000), IN ADDITION TO THE
:OST 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:
7 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,
"rmance of the work for which this permit is issued. Policy No.
Business and
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
one #
Date
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
if I should becom �subject to the workers' cc ppensatio rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iature of Applicant IAe) 117 / F
CLARATION REGARDING CONSTRUCTION LENDING AGENCY - C�
�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, Civil Code).
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 cou he above -identified property for inspection purposes. /'"''7� /I
nature of Property Owner or Authorized Agentt`t�� Print Propertv Owner's or Authorized Anent's Name J . D'Avi / C
DATE BY VDECLARATION OF I REGULATIONS PA T0MPLIANCE WITH CODE OF 61 Or TITLE 40AND AQMD RUDLE�L FOR OFFICE USE ONLY
PERMIT EXPIRED ❑ 1 5U BNdTTE1) AFBESTOS NOl, F I I ATION TO
PERMITCANCELLED EP,�
PERMIT EXTENDED ON D J
PERMITFINAL _ 58€STOS NOTIFICATION IS NOTAPPPLICAABBLE�TO
CERTIFICATE OF 5GNATURE:EXQ
OCCUPANCY ISSUED