HomeMy WebLinkAboutX2019-3461 - Permits�ro4� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-3461
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 9 3 4 6 1 Project No: 2656-2018
H Permit Counter Phone (949)644-3288
4� Inspection Requests Phone (949)644-3255
c nb ~ Combination Type - BLDG PLUM Issued Date: Area
: 2019
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Inspection Area 4
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
Job Address: 25 BURNConstruction ING TREE CIR Nours: 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 SulI*YSst(Holi� � r 1
Description: DEMO SFR 4,197 SF (4 BEDROOMS)AS BUILT, INCLDS SEWER CAP _ ! P
Legal Desc.: N TR 7638 LOT 50
Owner:
GOODMAN JOSEF & BITA
Contractor:
Address:
25 BURNING TREE RD
Address:
NEWPORT BEACH, CA 92660
Phone:
310-433-6023
Phone:
Applicant:
AHMADI MANSOUR
Con State Lic:
Address:
32262 VIA DEL SOL
Lic Expire:
TRABUCO CANYON CA 92679
Bus Lic:
Phone:
949-715-9990
Lic Exp Date:
Code Edit : 2016
Type of Construction: V-B
Occupancy Group: R3/U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 1
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Construction Valuation: $30
Building Permit Fee:
$103.00
Plan Check Fee: $0.00
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 :
$2.00
TOTAL FEE: $2,042.27
PROCESSED BY:
ZONING APPROVAL:
OWNER/BLDR
AUTH AGENT:
BOBBI
0/B
Worker's Compensation Insurance
Carrier:
Policy No:
Expire:
Building Setbacks
Use
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: I
Front: I
Left: I
Right: I
king Spa
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$9.27
Architect
Address:
Phone:
State Lic:
Engineer:
AHMADI MANSOUR
Address:
32262-VIA DEL SOL -
TRABUCO CANYON CA 92679 .
Phone:
949-715-9990 State Lic:C-076370 ,
Designer:
'
Address:
Phone:.
Special Conditions: CR & R TO HAUL DEBRIS
0
Planning Department -
Plan check Fee
Fair Share
SJH Trans:
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check:
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee : $0.00 Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPROVAL TO ISSUE:
$0.00
$0.00
$26.00
$210.00
$1,692.00
$0.00
Woo
$0.00
$2,042.27
a
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 below by the checkmark(s) I have placed next to the applicable item(s)
ction 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
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
fessions 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
liness 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
rove n e 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
urpose of sale).
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
ply 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).
U I am exempt from licensure under the Contractors' State Licen e following reason:
By my signature below I acknowledge that, except form onal re�+d nce in which Ism ILRtJaava
sell a structure that I have built as an owner -build hnnot Been constru di Ir1Ts entirety by
Professions Code, 's ev3ilable upon requ n th4s appl' lon is I ed or at the following 6
Signatur.� of Property Owner or Authorize g t /
L ICEW�ED cn,4TRACTOR'S DECLARATION
I herebv affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commen(
and effect. Licensj Class License No
for at least one year prior to completion of the improvements coyyyyyyered by thi.
contractors. I understand that a copy of the applicable law, Secjlon 7044 of
:http://www.leginfo.ca.gov/calaw.htm]. /
7000) of Division 3 of the Business and Pro
Date Contractor Signature
Code, and my license is in full force
VORKERS' CCAORZNSATION DECLARATION
,ARJING FAILURE l C. SE. URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
:OST OF COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby.afhrm under penalty of perjury one of the following declarations:
J I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
arFormsnce of the worn. for which this permit is issued. Policy No.
ha,(P and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
ranca carrier a,Id pcdicy number are:
of Agent
Policy Number Expiration Date
Phone #
'fy that, in the perfor oft ork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
t f I should becam )ect toto wo erlsatiompT Section 3700 of the Labor Code, I shall forthwith comply with those provisions
n ant
CLA ION REGAR CONSTRUCTION LENDING AGENCY
areby affirm under penalty of perjury that there is a construction lending agency forthe performance of the work for which this permit is issued (Sectio 97, Civil Code).
rder's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property own behalf. r.
1 have read this application and the information I have provi a correct. Q,��/ 111
I agree to comply with all applicable city and co my or � rites and state laws relating to building construction. /
I authorize representatives of this city or my to r th -identified property for inspection purposes.
mature of Property Owner or Autho gent _ Print Property Owner's or Authorized Agent'ate
ACTION
DA$E�
BY
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE U5E ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
PERMITEXPIRED
/
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
LIEPA
PERMITEXTENDED
OMD
PERMITFINAL
BEST S NOTIFICA N IS NOTAPPLICABLE TO
CERTIFICATE OF
2 C
PROPOSED U N
OCCUPANCYISSUED
% >
SIGNATUR
/ CS ,