HomeMy WebLinkAboutX2021-1355 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
aeivarw�`R Combination Type - SFP PLUM
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIII� II COMB Permit: X2021-1355
x 2 0 2 1 1 3 5 5 Project No :
Issued Date : 05/27/2021
Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 05/27/2024 OR PERMIT WILL BE INVALID
Construction Hours: 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 Sundays or Holidays
Job Address: 3 RIEZ NB
Description: SFR PEX RE -PIPE (12) FIXTURES
Legal Desc.:
Owner:
SHASHAANI GHOLAMREZA
Contractor:
INTEGRITY REPIPE
Architect:
Address:
3 RIEZ
Address:
927 CALLE NEGOCIO #D
Address:
Disabled Access :
NEWPORT COAST CA 92657
Hazardous Mat
SAN CLEMENTE CA 92673
Building Green Fee :
Phone:
$0.00
Phone:
877-473-7473
Phone: State Lic:
Applicant:
INTEGRITY REPIPE
Con State Lic:
993925
Engineer:
Address:
927 CALLE NEGOCIO #D
Lic Expire:
06/30/2022
Address:
Grading PC Fee:
SAN CLEMENTE CA 92673
Bus Lic:
BT30066794
General Service
Phone:
877-473.7473
Lic Exp Date:
0913012021
Phone: State Lic:
Code Edit: 2019
Type of Construction: VB
Occupancy Group: R3IU
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 2
No of Units : 1
Bldg Height: 0
Bldg Sprinklers:
Construction Valuation: $4.500.00
Building Permit Fee: $161.00
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 :
$1.00
TOTAL FEE: $176.49
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Designer:
Carrier:
CLEAR SPRING PROP & CASUALTY C Address:
Policy No:
CSWK0000050800
Additional Fee :
Expire:
09101/2021
Phone:
Building Setbacks
Rear: /
Special Conditions:
$0.00
Front: /
$0.00
Left: I
Grading PC Consultant:
$0.00
Right: I
Use Zone:
Parking Spaces: 0
Fire Hazard Zone : N
Excise Tax:
$0.00
Planning Department -
Fire Department
Additional Fee :
$0.00
Plan check Fee:
$0.00
Fire Inspection:
Grading Bonds Fee:
$0.00
Fair Share :
$0.00
Fire Plan Rev
Grading PC Consultant:
$0.00
SJH Trans :
$0.00
Demolition Fee
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
$0.00
Building Dept Adm
Grading PC Fee:
$0.00
Public Works Department -
General Service
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Refund Deposit
PAN Plan Check :
$0.00
Grading Bond:
Electrical %:
$0.00
San Dist:
$0.00
Mechanical W
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$14.49
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$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $176.49
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PLAN'C§1E0K BY:
APPROVAL TO ISSUE:
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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 provisiors-df 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).
❑ 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
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 legally
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
I hereby affirm under penalty of per uryry that am licensed under provisions of Chapter 9 (commencing with Section 700 of.Division 3 of the Business and P of 'ions Code d my license is in full force
and effect. License Class -S License No At, 14 2 r Date Contractor Signatg
WORKERS' 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 TH0 D DOLLARS 5100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I 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 the
perf rmance of the work for which this permit is issued. Policy No.
I have and will Sint tto workers' compensation insurance, a)i required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol
nsurance carrier a d polit number ary!`1 ^y ( � r
is of Agent �
certify that, in the I
. if I should becom
lature of Applicant
Date
I
ice 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 agre
to the workers' com ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ` /
Ptah
neby affirm under penjlty of perjury tyrther6 is a construction 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 Do ty ordinances tate laws relating to building construction. 1 �'
I authorize representatives of this city or coultiNdoo enter the -identified property for inspection purposes.
Signature of Property
Owner
or Aut
ACTION
DATE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED
vners or Authorized AD
BY I.
I RECVJfTTION OF LATIONS PARTO 1 OF IITLE 40 AND AQMD RULECE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
I SUBMITTED ASBESTOS
•
,TION TO
Ot}•PLICA6W* TO