HomeMy WebLinkAboutX2021-2219 - Permits,d; r�nrF4.r City of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111COMB Permit: X2021-2219
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 2 2 1 9 Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Issued Date : 08120/2021
Combination Type - SFP ELEC MECH PLUM
Inspection Area / Y
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0812012024 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: 3057 CORTE MARIN NS
Description: SFR -INTERIOR ALTERATION OF 3 BATHS. 249 SF (CITY STANDARD)
Legal Desc.:
Owner:
MODJTAHEDI BIJAN
Contractor:
HOME RENEW 360
Address:
3057 CORTE MARIN
Address:
3711 LONG BEACH BLVD STE 201
NEWPORT BEACH, CA 92660
LONG BEACH CA 90807
Phone:
Phone:
714-884-2063
Applicant:
LEVISOHN NOAM
Con State Lic:
982343
Address:
23414 ERWIN ST
Lic Expire:
03/31/2023
WOODLAND HILLS CA 91367
Bus Lic:
BT30076335
Phone:
818-220-9452
Lic Exp Date:
0813112022
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: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers: N
Construction
Building Permit Fee: $433.00
Plan Check Fee: $376.71
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $949.31
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier. STATE FUND
Policy No: 9144686
Expire: 10/13/2021
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Building Setbacks Rear: I Special Conditions:
Front: /
Left: I
Right: /
i�o 7nnc Parkinn Rnnres 0 Fire Hazard Zone : N
State Lic:
State Lic:
Excise Tax:
$0.00
Planning Department- Fire Department
Additional Fee :
$0.00
Plan check Fee : $52.00 Fire Inspection:
$0.00
Grading Bonds Fee:
$0.00
Fair Share : $0.00 PTA Rev
of =..
$0.00
Grading PC Consultant :
$0.00
SJH Trans : 0.,08 e rt n Fee
bti Dept Adm
$0.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee :?1 q, ! `,". $b �,! ullding
Works Deparlu Y:G General Service
$0.00
Grading PC Fee:
$0.00
Public ..✓
WQ Insp. Fee :
$0.00
Park Dedication : t 0.00 Refund Deposit
$0.00
P/W Plan Check: $0.00 Grading Bond::
$0.00
Electrical %:
$30.31
San Dist: $0.00
Mechanical %:
$17.32
NMUSD Fee: $0.00 1
$0.00
Plumbing %:
$38.97
$0.00
Plan Check Fee
: $0.00 Fee Due at Permit Issuance:
$949.31
PUBLIC WCRKS APPROVAL: _
r
PLAN CHECK BY:
APPROVAL TO ISSUE: __
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law far 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 Iicensure 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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered far 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).
❑ I 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 fallowing 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 perjurX that I am licensed under provisions of �'t�ter 9 (c mmencing with Section 700 f Division 3 of the Business and P ofe sions , and my license is in full force
and effect. License Class !i License No IY .C� �{ Date ZO(2/ Contractor Signatujyf
NORKERS' 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 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 th
mance Of the work for which this permit is issued. Policy No.
he 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' compensatio
Ira ce carrier and policy number are:
Policy Number Ll I Li W16K Expiration Date l (i( ,3/ -')-/
of Agent
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
I, if I should become subject to the wovke ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Xo/ '1
nature of Applicant _ Dated U ( Z e�U
CLARATION REGARDING C N� S�TRDCTION LENDING AGENCY _ V
Ireby 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
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 ab�ovr�- eenntified property for inspection purposes. +
nature of Property Owner or Authorized Agent. �XJid Print Prooertv Owner's or Authorized ADent's Nam.)(' r4011M Ip IIk
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
DATE BY ✓ DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
'REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
I SUBMITTFn ASBESTOS
ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
PROPOSED DEpWD 9QN
FOR OFFICE USE ONLY