HomeMy WebLinkAboutX2021-1360 - Permits (3)rEw4,r>? City of Newport Beach II IIIIIIII II I II IIIIIIIII IIIIIIIIIIIIIIIII II II COMB Permit: X2U21-1360
•4,pgj. + +. Community Development Department - Building Division X 2 0 2 1 - 1 3 6 0
> y 100 Civic Center Drive, Newport Beach, CA 9266D Plan Check NO : 1201-2021
L— '� Permit Counter Phone: (949) 718-1888 Issued Date : 06/16/2021
rt newportbeachca.gov/civic Final Date:
oa Combination Type - SFP Permit Status: Reissued
Work Class - Alteration Inspection Area : 3
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 : 2917 SILVER LN Legal Desc : N TR 3068 BILK LOT 19
Description: SFR STRUCTURAL KITCHEN, BATH (2) REMODEL, DOOR C/O WATER HEATER, FURNACE, HEADERS, ELECTRICAL IN (3) BEDROOMS **STOP WORK:
121-1489**
Owner: KAMFAR MIRRAFATI
Contractor: OWNER/BUILDER
Architect
Address: 2917 SILVER LN
Address :
Address:
NEWPORT BEACH, CA 92660
Phone : (949) 533-4650
Phone :
Phone
Con State Lie : OWNER/BUILDER
State Lie
Lie Expire
Applicant : KAMFAR MIRRAFATI
Bus Lie:
Engineer
Address : 2917 SILVER LN
Bus Lie Expire :
Address
NEWPORT BEACH, CA 92660
Phone: (949) 533-4650
Workers' Compensation Insurance
Phone
Carrier:
owner/Builder: KAMFAR MIRRAFATI
Policy No:
Designer
Address : 2917 SILVER LN
W. C. Expire:
Address
NEWPORT BEACH, CA 92660
Phone : (949) 533-4650
Phone
Code Edition : 2019
Fire Sprinklers : NO
Construction Valuation
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/Ti sq. ft. Bldg : 0
Occupancy Groups : U,R-3
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories : 1
Added/New sq. ft. Garage : 0
TOTAL sq. ft. : 0—
Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY:
-
SPECIAL CONDITIONS:
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(Section 7031.5. Business end Professions Cade: Any city or county that requires a permit Io construct, alter. Improve, dernolish, or repair any structure, prior to Its issuance, also requires the applicant for
the permit to file a signed statement that he of 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 703145 by any applicant for a permit subjects the applicant io a civil penalty of
not more than five hundred dollars ($500).
I, as owner of the property, or my employees with omegas as their sole compensation, will do L) 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 provingthat it was not built. or
Improved for the purpose of sale).
Ell, 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 Improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law),
n I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my per residence in which I must have resitcl or at least one year prior to completion of the Improvements covered by this permit, I cannot legal]
sell a structure that I have built as an owner bull, if it Ih not pen constructed in Netgtiy Ioensod contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code., Is available upon request when this ppli ion is or at the following Web site:http:liwww.leginfo.ce.govfcalaw.htmi. /f n
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 Professions Code, and my license is In full force
and effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU8JECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S10a,0001, IN ADDITION TO THE
OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEE$.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintaln 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
'ormance 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' compensa
trance carrier and policy number are:
Policy Number
of Agent
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 become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions,
Ignalure of Applicant _,.,,,_ .._.._.__ ________ Data
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby 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).
enders Name _ Lender's Address
ly 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 prooy!dV Is correct,
I agree to comply with all applicable city and county oj;ajffanAs and state laws relating to building construction.
I authorize representatives of this city ur covr.ty to rturt. - 1tea�Ewpcu2y for inspection purposes. (' /� /�
Iianature of Praoartv Owner or Authorized Ace.d � Print Property Owner's or Authorized AuenCs Name ..MYa/ / tt Date
ACTION DATE: BY �—T-rr_LP1WlONOF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART fit OF TITLE 40 AND AONID RUt.E
_ 11�NIItii
PERMIT EXPIRED j LJ I S'Jq AITTED A5BESTO.SNOTI FICATION TO
PERMIT CANCELLED
PERMIT EXTENDED
PeRNNT PUAL
59'/2-lf
CERT01CATEOF
OCCUPANCY IS5UEO
APPLICABLE TO