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Home My WebLink AboutX2015-2292 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIII II COMB Permit: X2015-2292 Fe 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 5 2 2 9 2 Project No : 0622-2015 Permit Counter Phone (949)644-3288 u 0 Inspection Requests Phone (949)644-3255 Combination Type - GRAD Issued Date : 08113/2015 Inspection Area : 6 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Job Address: 43 BRIDGEPORT RD NB Description: YARD DRAINAGE "CTY SYD" Legal Desc.: Owner: FIROUZABAD E VNTARY Contractor: ELITE CONSTRUCTION - Address: 43 BRIDGEPO T R a e: _ /pJ 23121 LA CADENA, STE 1-2 Address: NEWPORT C ST, CA 92657 erUNA HILLS CA 92653 I„� Phone: / ®Phone 949-699-3717 - If appl- le: Applicant: ELITE CONS UCZZ E r:Con State Lic 940597 ':'i.� El 8O0�r€r�9�p �er� DI ARA.S„H,.t 4 ' Address: 23121 LA CA NA2 Lic Expire 1140513112016 AddtesFs'' � `2525'E A1�ItiluuAV LAGUNA HIL CA Bustic T300445Qt q ORANGE CA 92869 Phone: 949-699-3717 Lic'E'xp-Dat . 1 iJ201tj1�Lto w,ho Ip(ine: 949-742-0148 tate Lic: C-078579 Code Edit: 13 orker's Compensation Insurance - Designer: Type of Construction:-->ar`�T7y�lE�QQ Address: Occupancy Group: Policy No 9052602 � _ Added /New sq.ft. Bldg: xpj 05/011201,6 Phone: Added /New sq. ft. Garage: 10 No of Stories: Building Setbacks Rear. / Special Conditions: - No of Units : Front: / Bldg Height: - Left: / Bldg Sprinklers: Right:Sp/ Flood Zone: se o arkin ac1_1 za e N Construction Valuation: $ .00 (W a U P101 I ork started Building Permit Fee: $0.00 Excise Tax: $0.00 Pla0w MWkeStarted) Fire De artment Plan Check Fee: n$Q,Qpo. Additional Fee : $0.00 Plan check Fee : $32.00 ,Are I pection: :n0.00� Overtime Plan Ck: 1 Fair Share : $0.00 "" ?"r'Fire an Rev - $0.00 Investigation Fee: $0.00 - Grading 7TMo700- SJH Trans : $0.00 Demol ion Fee Record Management $1.00 Grading Permit Fee: $253.00 In -lieu Housing ee : it ng Dept Adm $0.0n Energy Compliance: $0.00 0.00 Public Works Oil eqt, �F� Gen rat Service yu.uu CA Seismic Safety: $0.00 ibh• 51d.eljals: Ref dDeposit $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $286.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $286.00 PROCESSED BY: ^�( k_ � 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 reasons) 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U 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). J I, as owner of the property, am exclu eh poly to an owner of property who builds r in I I am exemptfrom licensure underthE Col ly my signature below I acknowledge th , ex ell a structure that I have built as an ow r-b 'rofessions Code, is available upon reg1J Stv lignature of Property Owner or Authorize Ac .ICENSED CONTRACTOR'S DECL kPi hereby affirm under penalty of perjury th t I ; nd effect. License Class VORKERS' COMPENSATION DEC AF DARNING: FAILURE TO SECURE WORKERS' COM NS DST OF COMPENSATION, DAMAGES AS PROVID PC hereby affirm under penalty of perjury o of I have and will maintain a certificate of erformance of the work for which this De nit have and wi'I maintain workers' con I•gn ,e carrier and policy number are: is cif Agent certify thatin the performance of the if I should become subject to theWd of contracting with licensed Contr tors to wconstruct the project (Section 7044, Business and Professions Code: The Contractors' tate License Law does not rww1heraon, and who co> foZeOolects with a licensed Contractor pursuant to the Coptractors' State License La). for my personal residen6e in Which I must have resided for at least one year prior to completion of the improvements coverIF by this permit, I cannot not be truc - in it tire by d o I under t i �cppq ®Ite��0%l rWLM9Jon 044 of the Business and this a catio su itte t t to n eb a p: eginfo.ca.gov/calaw.h ml. Date F%der provlslonso7 ChapTer'T(commencm with ecloprI 7iffYOMDiw'slo6-3-dithe BUSlne s and Professions-COde, and y Ic full force License No late R / r n/ I � Contra Signature -. lecla IS U LAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENA ES AND CIVIL FINES UP TO ONE HUNDRE etl' O DO R , IN ADDITION TO THE 6OF E LABOR CODE, INTEREST, AND ATTORNEY'S FEES _ self -insure for workers' compensation, issued by the Director of, Industrial Relations as provided for by Section 700 of the Labor Code, for th Policy No. r as required by Secti 3700 of the Labor th rfprmance of the wor for whi this permit is issped. My workers' compensatiol , ,can Sian ' Discarraat��an for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compens Ion laws of California, and zo�n on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DIP: ECLARATION ING AGENCY h^rerr•' a I m unde penalty of perjury th nce of the work for which this errinsp roll alq:'_0 11 Code). e�Ider S Name Lender's Address y my signature below, I certify to each of the following: - I ala the pIaporl� owner or authorized to act on the property owner's behalf. I have rear: this Lpplication and the information I have provided is correct. -" I agree to comply with all applicable city and county ordinab- te laws relating to building construction. I authorize representatives of this city onty,to�nt r thtifiedproperty for inspection purposes. J 1� i j - ignature of Property Owner or Authorized Agent f ry Print Property Owner's or Authorized Agent's �J�riie �0;10z ^ D-_IR r W6V to Ar7NN1 DATF 74V DECLARATIOMOFCOMPLIANCEWF(NCODE OF FU71uwu &Lway FEDERAL REGtILATIONS PART fif OF TITLE40 AND AOMDRDLE 9403. PFRf.VT FNP[RR7 OG ❑ ISfNtMlTTrn ASIYSTO-A;NnTIElr4TIONTO ❑ EPA ❑ AGMD PEXXTGAtICELLED PERAFrTEATENEIED ❑ ASBESTOS NOTIAGLTION LS NOT APPLICABLE TO PR7POSEDDEMOLITYIN. PERMIT TINAL GERT FTCATECF SfUNA I VUL: 0CCLDAIJCY;S5LlED