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Home My WebLink AboutX2020-0245 - Permitst.�,# City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIII�IIIIIIII� it COMB Permit y X2020-0245 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 0 2 4 5 Project No : 2139-2018 N `� �+ Permit Counter Phone (949)644-3288 v. ?3t Inspection Requests Phone (949)644-3255 r# r x* Combination Type - MFP ELEC PLUM Issued Date: 01/2912020 6 Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. 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: 513 1/2 MARIGOLD AVE NB Description: MFR WINDOW REPLACEMENT (8), UPGRADE EXISTING ELEC PANEL, KITCHEN REMODEL 65 SF *RENEW EXPIRED PERMIT* Legal Desc.: _^ ` �NSP�1-�*9C Owner: AHMADI LP Contractor: OWNERIBLDR Architect: GOETZ ANDREW,, //i/ `V I f� Address: 19 MUIR BEACH CIR Address: AHMADI BEHROOZ Address: 2855 E COAST HWY #234 NEWPORT BEACH, CA 92625 CORONA DEL MAR CA 92625 .... Phone: 949-677-0718 Phone: Phone: 949-673-3152 State Lic:C018499 ° • ° ° • Applicant: GOET Con State Lie: OIB Engineer: •B Address: 2855E COASTNDREW E COAST Lie Expire: Address: CORONA CORONA DEL MAR CA 92625 AR A 9 Bus Lie : ® ®��T��TIOI`d ��•°••• Phone: 949-6733152 Lie Exp Date: ° • ° Phone: State Lie: Code Edit: 2016 of Construction: R3 Occupancy Occupancy Group: R3 Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Rear: / Front: / Left: / Right: / Use Zone: Parking Spaces: Designer:Type Address: Phone: Special Conditions: 0 Fire Hazard Zone : • •• ON SATURDAYg�a• !�3 fl T • • • • ° • OWNER/BLDR FORM ATTACHED .... °„11°0 N °•� •°°.°° °°°°• „° ° ° ° ° Construction Valuation: $0.00 Building Permit Fee: $0.00 Excise Tax: $0.00 Planning Department- Fire Department Plan Check Fee: $0.00 Additional Fee : $116.00 Plan check Fee : $0.00 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: $0.00 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 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: $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 : $116.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $116.00 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,y 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). ❑ 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 legall) sell a structure that) have built as an owner -builder It has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 044 of the Business and Professions Codb,i &Vdilable upon request when Is applicatio is sub tted or at the follow)rJ� b site:hftp://wy0m.leginfo.ca.gov/calaw.html. .z Siena ture of Property Owner or Authorized Agent z C/ z /.�I— e.r�P /.�( D /-). 26 L�CENS�D CONTRACTOR'S DEC LARAT4ON I hereby affirm under penalty of perjury that I a licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions e, and my license is in full force aQd btfedt. License Class License No Date Contractor Signature WORKERS' COMREOSATION DECLARATION 4FU?IM%-%ILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10D,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES. hereby affirm underpenalty of perjury one of the following declarations: �J 0 6 p and will'fnaintain 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 olrf&ma(Ice of tp@ wp For which this permit is issued. Policy No. O64aue.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' compensatiol in%jjWpe carrier.4hWipbycy number are: Carrier "" Policy Number Expiration Date Name of Agent Phone # _JI certify that, in the pert rmance 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' cgrhpensation laws of California, and hat, if I should become bject o tthheworkers' compens rovlslon of ect�iorrt.-;3700 of the Labor Code, I shall forthwith comply with those provisions. � signatureof Applicant "`y%� C 1 Dater — q.IZO 2d )ECLARATION REGARDING CONSTRUCIWN LENDING AGENCY hereby affirm under f enalty 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). -enders Name // Lender's Address 3y 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 corre % _) , I agree to comply with all applicable city and county dinances and state laws relating to building construction. rtiC Gy / I authorize representatives of this city of county tof ter t e above-identifie p perty f ' spection purposes. 1 ,� �I,.',-r7�°Z signature of Property Owner or Authorized Agent I /'�U riot Property Owners or Authorized Agent's Name 1 Dat Z ' < ACTION DATE BY /I D 6 RATION F OMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ( EGULATIONS PART 61 OFTITLE 40 ANDAQMD RULE PERMIT EXPIRED 1 LJ I NUTTED ASBESTOS NOTIFICATION TO PERMITCANCELLED A PERMIT EXTENDED QMD PERMITFINAL ASBESTOS N TIFICATION IS NOT APPLICABLE TO CERTIFICATE OF 1 OPOSED D ,(,��t ITIO(�/ OCCUPANCY ISSUED NATURE' 9J , 1�'