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Home My WebLink AboutX2022-1491 - PermitsCOMB Permit -. X2022-1491 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII X 2 0 2 2 1 4 9 1 Project No : 2036-2021 100 Civic Center Drive, Newport Beach, CA 92660 -�� Permit Counter Phone (949)644-3288 ,.. r� Inspection Requests Phone (949)644-3255 Issued Date r r�` Combination Type - MFP Inspection Area : 5 ST VLID INSPECTION. PROJECTS MUST BE COMPLETED BY )INVALID OR PERMIT LL BE PERMIT ISSUANCE to 6A30 and Saturday from 8.•00 a.m to 6 00 p.m. No work on Sundays or Holidays Construction struct on Hours: MondayR Friday 7 00 a mA. p.m. Job Address: 438 GOLDENROD AVE NB R/R PATIO CANTILIVERED COLUMNS & (N) BEAM DUE TO ROT Description: DELTA E- Legal Desc.: CORONA DEL MAR BLK 434 LOT 22 Contractor: FLOORING KITCHEN & BATH DEPOT Architect: Owner: MEDALI REZA Address: 701 S RAYMOND AVE #1 Address: Address: 3136 E ABBEY LN FULLERTON CA 92831 ORANGE, CA 92867 Phone: 714-870-1575 Phone: State Lic: Phone: 626-485-8277 Engineer: ZAKERI BEHZAD Applicant: HAJIALI AHMAD Con State Lic; 965892 09/30/2023 Address: 13628 FREEPORT RD RAYMLic Expire: Address: 701 S AVE BT30053966 SAN DIEGO CA 92129 RTON, CA 1 Bus Lic: FULLS 9284 CA Lic Exp Date: 02128/2023 Phone: 714-600-0182 State Lic:C-089670 2271 Phone: 949-637-2271 2019 workers Compensation Insurance Designer: Code Edit Carrier: INS OF THE WEST Address: : Type of ConstructionNo: R2/U Policy 50 WSA504074704 Occupancy Group: Expire P 0411612023 Phone: Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 Building Setbacks Na of Stories: 0 Rear: / Special Conditions: Front: I e-+t ,^s��..� LCT i t No of Units: 2 Left: / I V Bldg Height: 0 Right: I Bldg Sprinklers: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Flood Zone: nstruction Valuation: $3 000.00 ilding Permit Fee: $127.00 Excise Tax: $0.00 Planning Department - Plan check Fee : $$0.00 Fire Department Fire Inspection: 0.0 n Check Fee: $110.49 Additional Fee : $0.00 Grading Bonds Fee: $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 DeBuild[ngnFee ertime Plan Ck: eFee: $0.00 Grading PC : [,stigation $0.00 I0.00 eurans $0.00 Housing Fee : $0.00 Dept Adm $0.00 ord Management : $12.00 Grading Permit Fee: n-lieu $0.00 Public Works Department - General Service $0.00 $0.00 ergy Compliance: $0.00 Grading PC Fee: WO Insp. Fee: cation : $0.00 PM Refund Deposit Grading Bond: $0.00 Seismic Safety : $0.00 Plan Check: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 $0.00 Plumbing %: $0.00 Plan Check Fee : $162.49 Fee Due at Permit Issuance : $140.00 TOTAL FEE : $302.49 PUBLIC WORKS APPROVAL: PROCESSED BY: �J PLAN CHECK BY: ZONING APPROVAL: APPROVAL TO ISSUE: GRADING APPROVAL: 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 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 Iicensure 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 700) o Division 3 of the Business and Professions de,td my license is in full force and effect. License Class License No Date �� Contractor Signature Ll/ //� NORKERS' COMPENSATION DECLARATION Y YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE 'DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION JT06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 the Vrmance 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: of Agent Policy Number Expiration Date oH— x JI 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 agre iat, if I should become subject to th ,5 workers' compensation pr isions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iignature of Applicants D//�z.J2Z IECLARATION REGARDING CONSTRUCTION LENDING AGENCY C hereby affirm under penalty of perjury that thereis a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). order's Name Lender's Address Iy 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 county to enter the abo a property for inspection purposes, ignature of Property Owner or Authorized Agent � print ProDertv Owner's or AuthnH,Pn Ki—c-V ACTION BY D LA ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERTP4 I SUBMITTED ASBESTOS NOTIFICATION TO PER EPA PER QM D PERMIT FIN CERTIFICAT ASBEST TIFICATION IS NOT APPLICABLE TO OCCUPANC1?./ / _✓ PR DDEMOLITION ..,...-_.._- 2