HomeMy WebLinkAboutXR2023-2228 - PermitsaEWPORT City of Newport Beach II II IIIII II IIIII I IIII IIII II II III I II COMB Permit : XR2O23-22,28
0� Community Development Department -Building Division x R 2 e 2 3 2 2 2 8
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check NO : PC2023-1957
Permit Counter Phone: (949) 718-1888 Issued Date : 0813112023
newportbeachca.gov/civic Final Date:
Combination Type - MFP ELEC MECH PLUM Permit Status: Issued
Work Class - Alteration Inspection Area : 4
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: 51 SEABROOK COVE Legal Desc : N TR 9676 BLK LOT 11 UN 71 TR 9676 LOT 11 UNIT 71
Description: MFR- INTERIOR ALTERATION INCLUDING KITCHEN, BATH, NEW BI-FOLD DOOR 1450 SF
Owner: KENNETH GARDNER
Address : 51 SEABROOK COVE
NEWPORT BEACH, CA 92660
Phone: (650)773-0631
Applicant: OMID SOUTEHKASHAN
Address : 3103 W CENTRAL AV
SANTA ANA, CA 92704
Phone: (949)690-0098
Owner/Builder :
Address :
Phone:
Contractor: OMID SOUTEHKASHAN
Address : 3103 W CENTRAL AV
SANTA ANA, CA 92704
Phone:
(949)690-0098
Con State Lic
: 923935
Lic Expire :
12/31/2024
Bus Lic :
BT30082519
Bus Lic Expire : 08/31/2024
Workers' Compensation Insurance
Carrier: NO EMPLOYEES
Policy No: EXEMPT
W. C. Expire:
Architect
Address
Phone:
State Lic:
Engineer: MOBED MEHDIABADI SASAN
Address: 3842 HENDRIX ST
IRVINE, CA 92614
Phone: (310)433-7927
Designer:
Address
Phone:
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation :
$120,000.00
Type of Construction :
V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg :
0
Occupancy Groups :
R-2
No of Units :
1
Alteration sq. ft. Bldg :
1,450
Bldg Height:
No of Stories :
2
Added/New sq. ft. Garage :
0
TOTAL sq. ft.
0
Building Setbacks
Flood Zone :
X
Use Zone :
PC - Sea Island Apartments
PROCESSED BY:
'
SPECIAL CONDITIONS:
oil- Lzla
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Lawfor 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 far
:he 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
Profess ons Code) or that he or she is exempt from fcensure 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
lot more than five hundred dollars ($500),
1, 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,
3USheSS 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
mprovements 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, Be 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 properly who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors State License Law).
I am exempt from licensure under the Contmctors' State License Law for the fallowing 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 )agally
sell a structure that I have built as an owmor-builder if Ithas not peen constructed in Its entirety by licensad 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:f/www.feginfo.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 7000) of Division 3 of the Business and PrOfe5510 Code, nd. my Ilse Is In full force
and effect. License Class License No Date $/ 11.2 Z Contractor Signature,/,<- —
✓PORKERS' COMPENSATION DECLARATION
NARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0T0S OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
�h-Iereby affirm under penalty of perjury one of the following declarations:
,_.t 1 have and will maintain a certificate of consent (o self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
performance of the work for which this permit is issued. Policy No.
have 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'
ranee carrier and policy number are:
Policy Number
of Agent
Dale
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 become subject to the wo Vers' compensaWn provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions.
of
Data lr�3
areby 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).
)der's Name _ _ Lenders 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 represen(ativer ^f thit. Lity oI Lountd gBfi �r khhe Wi Le-identifi roperty for inspection purposes. ,-Is I I e-7) -4 /
Owner's or Authorized Acent's Name
Date ?13I z3
ACTION
DATE Fly i DEC.LARAI ION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 51'OFTITLE nO AND ACMD RULE
PERMIT EXPIRED
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i LJ I SLIRMITt ED ASBESTOS NOTIFICATION TO
PER+MfTCANCF.LLED
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PER14IT EXTENDED
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PERMIT flNAL
CERTIFICATE OF
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II /� } [Cf ASBESTOS NOTIFICATION 15 NOTAPPLICA9L 10
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OCCUPANCYISSUED
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