The URL can be used to link to this page

Home My WebLink AboutX2016-1610 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111111 11 COMB Permit: X2016-1610 o` 0 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 6 1 6 1 0 Project No Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Issued Date : 05/13I2016 �wcrov*'* Combination Type - SFP x Inspection Area : 4 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. - INSTALL OR VERIFY SMOKE(CARBON MONOXIDE DETECTORS /PLUMBING FIXTURES TO BE UPGRADED _ Job Address: 10 BELCOURT DR NB Description: SFR CHANGE OUT (5) WINDOWS (CITY STD PLAN) Legal Desc.: TR 11451 LOT 1 UNIT 9 OF PROJECT LOCATED ON AP 442-371.05 TOGETHER Owner: PIRNAZAR RAHMAT & M 2013 TRUST Contractor: RENEWAL BY ANDERSEN OF OC Architect: Address: 10 BELCOURT DR Address: 22982 ALCALDE DR Address: NEWPORT BEACH, CA 92660 LAGUNA HILLS CA 92653 State Lic: Phone: Phone: 714-259-5120 Phone: Applicant: RENEWAL BY ANDERSEN OF OC Con State Lic: 990416 Engineer: Address: 22982 ALCALDE DR Lic Expire: 02128/2018 Address: LAGUNA HILLS CA 92653 Bus Lic: BT30046925 Phone: 714-259-5120 Lic Exp Date: 04/30/2017 Phone: State Lic: Code Edit : 2013 Worker's Compensation Insurance Designer: JANOSIK STEVE Type of Construction: VB Carrier: EVEREST NATIONAL Address: 22982 ALCALDE DR Occupancy Group: R3/U Policy No: CA10002426 LAGUNA HILLS CA 92653 Added /New sq.ft. Bldg: 0 Expire: 01/01/2017 Phone: 714-259-5120 Added /New sq. ft. Garage: 0 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units : 1 Front: / Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $4,100.00 Building Permit Fee: $138.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $120.06 Additional Fee : $0.00 Plan check Fee : $37.50 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 $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: Hazardous Mat $0.00 Electrical $0.00 San Dist: $0.00 $0.00 Building Green Fee : $1.00 Mechanical W $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 TOTAL FEE : $298.56 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $298.56 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: 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 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 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). ❑ 1, 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, 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). ❑ 1 am exempt from licensure 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 Ieg811) 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 following 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 perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) f Division 3 of the Business and Pro s io Code nd my license Is i full force and effect. License Class License No Date- '' Contractor Signat 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 D S ($100,000), IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 prmance of the work for which this permit is issued. Policy No. have and wl m ain 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' rance carrier arld D icv number area I _ Date of 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 subje�ct to ttbworkers' compensation provisions of,54iIction 3700 of the Labor Code, I shall forthwith comply with those provisions. of Applicant to rJ j3� l� CLARATION REGARDING CONSTRUCTION EN ING AGENCY :reby affirm under penalty of perjury that there' a nstruction 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 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 a the above -identified propedy f inspection purposes. `` 1 nature of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's Nama�6' C_ VZ_ -J.A dos I IC-- ACTNHV DATF RY! HCOEIOF DCFAARATIO O MCE COMPURqART HME*Frrz ink (my, 61 FEDPFa,r,,.rrTFxwrtFn d4NTDR�2L 7d0?. ❑ litiltl:^lT�TD dSFYS': (1S Nll7TLM.dT"KY,J T'1' ❑ EFa ❑ 4CME PCl ivl4 CACFCYLLfD PERIAFT EYTENOED ASBESTOS M07IRCA770H IS NOT APPLICABLE TO Pl��OJJJJJPOSED DEMOL/TUId. PERMIT TPRAL 05/Z6��b / �. CER7FTCATECF OCCnJDANCYfSSLOED K G urn