HomeMy WebLinkAboutXR2023-3320 - PermitsP�sno�r City of Newport Beach IIIIIIIIII IIIIIIIIIIIIII,IIIIIIIIIIIIIIIIIII II COMB Permit : XR2023-3320
Community Development Department- Building Division X R 2 0 2 3 3 3 2 0
,> y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2005
Permit Counter Phone: (949) 718-1888 Issued Date : 1112912023
u S
_ newportbeachca.gov/civic Final Date:
Combination Type -MFP ELEC MECH Permit Status: Issued
Work Class - Alteration Inspection Area : 7
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: 3121 COAST HWY W, 8B Legal Desc : N TR 919 BILK LOT L UN HOLD TR 919 LOT L ELY1/2; HO
Description: MFR - CHNGE BED 2 TO WIC, RELOCATE BED 2 TO ORIG LOCATION, ADD (N) WINDOWS BTW BATH & WIC, ADD RECESSED LIGHTING & LED LIGHTING,
ADD WALL HEATERS ON INTR WALLS, PROVIDE DETAIL FOR FLR PENETRATION
Owner: NABIL B KASSIH
Contractor :
Architect
Address : 3121 W COAST HWY, 8B
Address :
Address
NEWPORT BEACH, CA 92663
Phone : (909) 973-0507
Phone :
Phone
Con State Lie :
- State Lie
Lie Expire
Applicant: NABIL B KASSIH
Bus Lie :
Engineer:
Address : 3121 W COAST HWY, BB
Bus Lie Expire :
Address
NEWPORT BEACH, CA 92663
Phone : (909) 973-0507
Workers' Compensation Insurance
Phone
Carrier :
Owner/Builder: NABIL B KASSIH
Policy No:
Designer: NABIL B KASSIH
Address: 3121 W COAST HWY, 8B
W. C. Expire:
Address: 3121 W COAST HWY, BB
NEWPORT BEACH, CA 92663
NEWPORT BEACH, CA 92663
Phone : (909) 973-0507
Phone : (909) 973-0507
Code Edition : 2022
Fire Sprinklers :
NO
Construction Valuation : $5,000.00
Type of Construction : V-B
Fire Hazard Zone :
NO
Added/New/TI sq. ft. Bldg : 0
Occupancy Groups : U,R-2
No of Units :
1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories :
B
Added/New sq. ft. Garage : 0
TOTAL sq. ft. 0
Building Setbacks
Flood Zone : AE, 8 FT; X; X
Use Zone : MU-W 1 - Mixed -Use Water
PROCESSED BY: /L
SPECIAL CONDITIONS: REV2023-2327
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 ftem(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 I!carsod 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 {!censure 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 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 ooe year of completion, the Owner -Builder will have the burden of proving that it was iiot built or
Rriprovod for the purpose of sale).
❑ 1, 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
lapply 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).
lI] 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, ! cannot legall)
sell a structure that I have built as an owner-buildor if it has not been construct d-in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 f tho Business and.
Professions Code, is available upon request when this application Issyortyytrt'et the folio log Wets sita:http/Iavtiv+4.leginfo.ca..gotdcalaw.html. f
i
Signature of Property Owner or Authorized Agent _ __ ,__ , _�M'�_ Date
(LICENSED CONTRACTOR'S DECLARATION _.5.
'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, andmy license is in full force
land effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
'ARNING: 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 (6100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 IN
erformance 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'
ranee carrier and policy number are:
Policy Number Expiration Date
of Agent Phone #_
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.
ignature of Applicant __^„_,__ _ _____ Date_
rECLARATION REGARDiNGSTRttCTION 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).
tinder's Name tenders Address
y 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 enter the above-Idenfifgd property for inspection purposes.
lionature of ProDertv Owner or Authorized Aaent % - - Print Property Owner's or Authorized ADent's Name
ACTION
i DATE
BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
i REGULATIONS PART 61 DF TITLE 40 AND AQNIn RULE
14103 _
i 3J15UB,,4ITTEii ASBE,,TC5 NOTIFICATION TO
FOR OFFICE USE ONLY
PERMiTEXPIREO
PERM17 CANCELLED
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