HomeMy WebLinkAboutH2021-0432 - Permits (3)aoRr
City of Newport Beach
C ' A
Community Development Department- Building Division
;..°'
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
CgG/F00.N�P
"
newportbeachca.gov/civic
II I II II IIII I I II Mechanical Permit : H2O21-0432
Plan Check No : 1201-2021
Work Class : Other
Issued Date : 0712212021
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: MECH NEW A/C UNIT *TAMPER PROOF CAP REQ*
Owner: KAMFAR MIRRAFATI
Address : 2917 SILVER LN NEWPORT BEACH, CA 92660
Phone: (949)533-4650
Applicant : KAMFAR MIRRAFATI
Address : 2917 SILVER LN NEWPORT BEACH, CA 92660
Phone : (949) 533-4650
Owner/Builder : KAMFAR MIRRAFATI
Address : 2917 SILVER LN NEWPORT BEACH, CA 92660
Phone: (949)533-4650
Code Edition :
Type of Construction
Occupancy Groups:
Fire Hazard Zone : NO
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:
dd
SPECIAL CONDITIONS: ,,IN
Contractor : OWNER/BUILDER
Address
Phone:
Con State Lic: OWNER/BUILDER
Lic Expire
Bus Lic:
Bus Lic Expire:
Workers' Compensation Insurance
Carrier :
Policy No
W. C. Expire:
Manufacturer
Model# :
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) Indicated below by the checkmark(s) I have placed next to the applicable items)
(Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to ifs 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' Stato 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 sale compensation, will do I_) all of or L) 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 fD 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 oneyear of completion, the Owner -Builder will have the burden of proving that It was not built or
improved for the purpose of safe).
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
'ramp -ply to an owner of property who builds or Improves thereon, and who contracts for the projects with a Ilcensed Contractor pursuantto the Contractors' State License Law).
L[ I and exempt from ficensure under the Contractors' $late License Law for the following reason,,:�
By my signature below I acknowledge that, except for my P o al residence In which ast9Tave resided for at least One year prior to completion of the improvements covered by this permit, I cannot ]&gall!
sell a structure [fiat I have built as an owner -builder if it n been constru Its entirety by licensed contractors. I understand that copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request w^hen this pp ` ation Is tied or at the following Web gite:http�/1�.leginfo.ce.gov)calaw.html.
.leglnfo.ce.gov)calaw.html. /) / p' / q
Signature of Property Owner or Authorized Agent � _ Date L L 4y
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
iKERS' COMPENSATION DECLARATION
ING: FAILURE TO SECURE wONIhERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000), IN ADOmON TO THE
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:
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
armance 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
rance 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.
nature of Applicant___..__.____._...._..___..._,__......__..,._m..._._.._._....._ Date—,
CLARATCIN REGARDING CONSTRUCTION LENDING AGENCY
!reby affirm under penah' of perjury that there is a construction lending agency far the performance of the work for which this permit is issued (Section 3097, Civil Code).
]der s Name Lender's Address
my signature below. I c&rtiiy 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 havepEolded is correct.
I agree to comply with all applicable city and count rd)aces and state laws relating to budding construction.
I authorize representatives of this city or counlyX en r the ab Ified property for inspection purposes. (� M
mabirP of Prnnadv Owner or AuthRaert orized " L PrintProoe-tv Owner's or Authorized Aaenl's Name Ijw rn 1 , r / L `Id
ACTION
DATE
BY - DECLARATiiON OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
ttr001. A,lON5 PART 61 OF TITLE 40 AND AQMD RULE
1403
PLAMIT EXPIRED
I SUBMITTED ASRFSTO$ NOTIFICATION TO
PERMiTCANCELL£D
'rpn
PE.RMITEXTENDED
_
'
PFRMIT FINAL
`S�QZ �Z�
_GAQMD
I ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF
PROPOSED DEMOLITION
OCCUPANCY ISSUED
SIGNATURE:
z
Z
CW
C
W
W
Q
J
W
w
J
w
H
O
Z
MC
LM
M
56
❑
c
�—
a
0
'D
3
C
a,
v
u
a
x
w
o
O
O
�
a
N
Y
Y
t
C
�
C
O
-'
O
7
E
°J
m
�
Y
Y
C
�
y
N
L
H
C
�
�
Q
-❑
Y
.y�
a
L
Cp
N
L
-
'L
a
O
C
r
o
c
Ln
j
u
a
a
Ln
oo
E
w
U
C
N
'O
w
>
O
X
^
7
E
E
�
1
m
U
¢
cc0
?
G
d
on
y
1
3
o
0
a
N
O
C
O.
v
u
a,
3
a`
m
ai
m
_
Y
Z
❑
i
v
a
L
a
Ln
c
Ln
o
ai
O_
c
ai
s
a
ai
-o
^ 1
V
C
U
u
Ln
n`
axi
°
LD
Y
c
u
u
N
L
Y
m
v
L
Y
Y
VI
Y
m
T
7_
u
d
a
p�
O
�{
T
m
C
ar
a
`w
C
�
L
n
a!
1
C
c
3
o
O
>
T
(
a
o_
o
a
a
a
ar
c
v
a0
O
u
w
t
C n
v
a
a
r
0
V /
L
°
c
v
m
z
Y
ar
v
C
N
C
O�-/
m
�
•m
c •
OQ
v
m
a
a