HomeMy WebLinkAboutXR2023-2295 - PermitsW, ,r City of Newport Beach 111���pI��111111111111111p11111 ����������������111111111COMB Permit : XR2O23-2295
o �j o' Community Development Department- Building Division
��, D. 1 DO Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2005
Permit Counter Phone: (949) 718-1888 Issued Date : 0911212023
newportbeachca.gov/civic Final Date:
<n-o W, Combination Type - MFP ELEC MECH PLUM 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: SFR REMODEL - CREATE 2ND BEDROOM & BATHROOM TO RETURN UNIT TO ORIGINAL 2BD/2BTH. **123-0754**
Owner:
NABIL B KASSIH
Address :
3121 W COAST HWY, 8B
NEWPORT BEACH, CA 92663
Phone:
(909)973-0507
Applicant:
NABIL B KASSIH
Address:
3121 W COAST HWY, 8B
NEWPORT BEACH, CA 92663
Phone:
(909)973-0507
owner/Builder: NABIL B KASSIH
Address : 3121 W COAST HWY, 8B
NEWPORT BEACH, CA 92663
Phone: (909)973-0507
Contractor
Address :
Phone:
Con State Lic
Lic Expire
Bus Lic:
Bus Lic Expire
Workers' Compensation Insurance
Carrier:
Policy No:
W. C. Expire:
Architect
Address
Phone:
State Lic
Engineer: NABIL B KASSIH
Address : 3121 W COAST HWY, 8B
NEWPORT BEACH, CA 92663
Phone: (909)973-0507
Designer: NABIL B KASSIH
Address: 3121 W COAST HWY, 8B
NEWPORT BEACH, CA 92663
Phone : (909) 973-0507
Code Edition :
2022
Fire Sprinklers :
NO
Construction Valuation :
$40,000.00
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 :
500
Bldg Height :
No of Stories :
8
Added/New sq. ft. Garage :
0
TOTAL sq. ft.:
0
Building Setbacks
Flood Zone :
AE, 8 FT; X; X
Use Zone :
MU-W1 - Mixed -Use Water
PROCESSED BY:
of-
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I ant exempt from the Contractors' State License Law for the reasen(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 fieensure 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 Contr arbors' 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) -
El 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not
apply to an owner of propertywho builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ I are exempt from licensors under the Cuhtraclors' Slate License Law for the following reason
By my Sig noluro below I acknoigo fiat. except for my pots aItaI residence in which I must have rasid ed for at [oast one year prior to completion of the improvements covered by this permit, 1 cannot Iago 11
soil a structure that I have built as an owner-buildor if it has not been constru tad in its entirot 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 a pI ti s I rat lief Ing Web site:http.LWww.leginfo.ca.gov)calaw.html.
Signature of Property Owner air Authorized Agent,,
�'�"—"—"'—'—__W_�__ _____.�._..__.__�..._ Date _ .L,�_,.�L...,..._______.
LICENSED CONTRACTOR'S DECLARATIO
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
WARNING: 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 ($100,000f, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and Will maintain a corl'rtieate of consent to self -insure for Workers' Gompensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thr
performance of the work for which [his 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
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
I( I should become subject gA7la orker o)n r salion era Asgd% of Section 3700 of the Labor Code. I shall forthwith comply With those provisions.
of Applicant ./y. mow.
CBIe—
I hereby affirm under penaity, 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).
L.endor's Name Lenders Address
By n1y signaLtxre below, I oedify fJ each of tl4a following:
I am the property owner or autiorizact to act on the properly owner's behalf.
I have read this application and the information 1 have provided is correct.
I agree to comply with all applcablo city and county ordinances and s t aws rel ling to building. construction.
I authorize representatives of this city or county toe ter t o`v p eny for inspection purposes. �l
Signature of Property Owner or Authorized Agent Print Pro Deny Owner's or Authorized Agent s Name Date
ACTION i DATE. l By 1 DECLARAT€ON OF COMPLIANCE WITH CODE OF F6'.DC.RAL FOR OFFICE USE ONLY
I RFGLILATIONS PART 61. OF 1'ITLF. 40 AND Al Rlll.E
_ 1R03
PERMIT EXPIRED 0 SUBMITTED A5RFSTOS NOTIFICATION TO
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PERA,eI FINAL ED ugOMp
R,bAf hINAL SBESIOSN0IIFICAN N Not APPIICA811 10
CERPF9CATE OF d� I� PROPOSED DF,Lt IT
OCCUPANCY ISSUED i __ SIGNATURE