HomeMy WebLinkAboutX2018-3218 - PermitsCity of Newport Beach - Eud6irg DV -ion IIIIIIIIII III II IIIIII IIIII III I II COMB Permit: X2018-3218
160 Civic Center Drive, Newpn t Bza..h, „A 9So63 x 2 0 1 8 3 2 1 8 Project No : 2507-2018
Permit Counter Phone (949)644-3288
y Inspection Requests Phone (949)644-3255 Issued Date : 10/3012018
Combination Type - NFP El EC 11'F.r:H PLUM
Inspection Area : B
PERMITS EgPIIfE s80 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Construction Hours: Monday - Friday 7:00 a:m. ti'o 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays
Job Address: 392 VILLA POINT DR NB
Description: MFR REMODEL KITCHEN, GUEST 8 MSTR BATHROOMS (276 SF)
Legal Desc.: TRACT 11937 LOT 2 OF PROJECT 939-63 LOCATED ON AP 442-411-it
Owner: SERVATI HAMID Contractor: OWNER/BLDR Architect:
Address: 510 SAVAGE RD Address: TRUJILLO BRIGIDO Address:
BELLEVILLE, MI
Phone: Phone: 714-657-0161 Phone: State Lic:
Applicant: JAFARI MASOUD Con State Lic: O/B Engineer: JAFARI MASOUD
Address: 23 ORCHARD #250 Lic Expire: Address: 23 ORCHARD #250
LAKE FOREST CA 92630 Bus Lic: LAKE FOREST CA 92630
Phone: 949-206-9929 Lic Exp Date: Phone: 949-206-9929 State Lic:S-003812
Code Edit : 2016 Worker's Compensation Insurance Designer:
Type of Construction: V-B-SPR Carrier: Address: a ray
Occupancy Group: R21U Policy No:
Added /New sq.ft. Bldg: 0 Expire: Phone:ccTOR
Added /New sq. ft. Garage: 0 m'Vr
No of Stories: 2 Building Setbacks Rear: I Special Conditions:
No of Units : 8 Front: I
Bldg Height: 0 Left: I
Bldg Sprinklers: Right: I
Flood Zone: X Use Zone: Parkinq Spaces: 0 Fire Hazard Zone : N
Construction Valuation: $22,000.00
Building Permit Fee: $424.00 Excise Tax: $0.00 Planning Department - Fire Department
Plan Check Fee: $368.88 Additional Fee: $0.00 Plan check Fee: $40.00 Fire Inspection: $0.00
Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00
Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee
Record Management: $2.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00
Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00
CA Seismic Safety: $0.00 WQ Insp. Fee : $0.00 Park Dedication : $0.00 Refund Deposit $0.00
Disabled Access : $0.00 PAN Plan Check : $0.00 Grading Bond: $0.00
Hazardous Mat $0.00 Electrical %: $29.68 San Dist: $0.00
Building Green Fee : $1.00 Mechanical %: $16.96 NMUSD Fee: $0.00 $0.00
Plumbing %: $38.16 $0.00
TOTAL FEE : $920.68 Plan Check Fee : $408.88 Fee Due at Permit Issuance : $511.80
PROCESSED BY: PUBLIC WORKS APPROVAL:
ZONING APPROVAL: 1' PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
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 belov' b,* tha cn=.ckmLrk(s, i'h'ave 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, demoli-f., o. repair any structure, prior to its issuance, also requires the applicant fo
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,app9eant for p'permi4 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 (_) portions of the work, end thestl ucrurc, 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 emplDyees' 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
�yto 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).
m exempt from licensure under the Contractors' State License Law for the following reason:
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-builde 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 p I ubmitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Age Date's ( i n - 30 ALICENSED CONTRACTOR'S DECLARAT ���
I hereby affirm under penalty of perjury that I am licensed un er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. License Class License No Date Contractor Signature
WORKERS' 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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
3erformance of the work for which this permit is issued. Policy No.
:3I 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' compensatiol
nsurance carrier and policy number are:
Policy Number
of Agent
Date
ertify that, in the performance of the work forwhich 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
:ha if I should become subject to th wor rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n
Signature of Applicant Date v
DECLARATION RE IN NSTRC400N LENDING AGENCY
hereby affirm under penalty of rjury 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
3y 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 t mar the above -identified property for inspection purposes. - 1I -t 0,,
Signature of Property Owner or Authorized Agent Print PropertyJ Owner's or Authorized Agent's Name '(� 1a fo ? l Date O� _
ACTION DATE BV DE RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED EPA
PERMITEXTENDED Anhnn ?
PERMITFINAL ASBESTOS NOTIFICATION IS NO APPLICABLE TO
CERTIFILATEOF �/ Vr/ P
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