HomeMy WebLinkAboutP2022-0280 - Permitsati%PORT
City Newport Beach
IIII I I II
I II I II II I II I II II
Oe @
uoif
DevelopmenDepartme
t nt- Building Division
Plumbing PermitCommnty
> i
100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No:
n
Permit Counter Phone: 949 644-3288
)(949)
Work Class : Other
Inspection Requests Phone 644-3255
Issued Date : 09/28/2022
5�/FOAN��
newportbeachca.gov/inspections
Inspection Area : 6
P2022-0280
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 : 10 WAYSIDE Legal Desc
: N TR 16464 BLK LOT 6 TR NO 16464 POR OF LOT 6 & 7
Description: PLUM TAN KLESS WATE RHEATER CHANGE OUT `
Owner: MAHINDANESHMAND
Contractor:.
Address : 10 WAYSIDE DR NEWPORT BEACH, CA 92657
Phone : (949) 929-8541
,�a„,.
Address : �'�? y Tq
Phone: iJ
Con StateLie
Applicant: MAHIN DANESHMAND
Lie Expire:
Address : 10 WAYSIDE DR NEWPORT BEACH, CA 92657
Bus Lie:
Phone : (949) 929-8541
Bus Lie Expire:
Workers'. Compensation Insurance
Owner/Builder: MAHINDANESHMAND
Carrier:
Address: 10 WAYSIDE DR NEWPORT BEACH, CA 92657.
Policy No:
Phone : (949) 929-8541
- W. C. Expire:
Code Edition: 2019
Fire Hazard Zone :. YES
Type of Construction :
Occupancy Groups
Building Setbacks :
Flood Zone: X
Use Zone: PC - Newport Coast
PROCESSED BY:
SPECIAL CONDITIONS: O/B FORM ATTACHED
d@ ffii• ii9 J aQ d J
J,il i
J p 3
a L,
J
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat I am exempt from. the CDntractors'State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicahte items)
(Section 70315, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair anystructure, prior to its issuance, also requires the applicant for
the permit to file a signed statement thathe or she is licensed pursuantto theprovisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 9 of the Business and
Prefessions Code) or that he or she is exempt from lieensure, and the basis for the alleged exemption. Any violation of Section 703t5 by any applicant fora permit subjects the applicant to a civil penalty of
not more five hundred dollars ($500).
El 1; as owner of the property,.: or my employees with wages as their sole compensation, will do L) all of or C) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Codes The Contractors' State License Law does not. apply to an owner of property who, through employees' or personal effort, buildsor improves the property, provided that The
improvements are not intended or offered for sale. It, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or
iriliproved for the: purpose of sale).
017�er 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).
11 f am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below i acknowledge that, except for personal residence in which I must have resided for at least one year prior tocompletionof the improvements covered b this permit, I cannot Iegall
sell a structure that I have built as an owner -build if has not boon canstmctad in'its ontitet�� by licensed contractors I understand that a copy of the applicable law, Soctio 4 of the Business and
Professions Code, is available upon request whe application(a-s4bmitted at the followh'gp Web site:http:ftwww.leginfo.ce.gov/colaw,html.
Signature of Property Owner or Authorized Agent/�__ ) //�\ Dat/T`"_`__.__2
LICENSED CONTRACTOR'S DECLAR) N
1 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
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKEFUT COMPENSATION COVERAGE M UNLAWFUL,AND SHALL SUBJECT. AN EMPLOYER TO CRIMINAL PENALTIES AND GIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($300A00), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby Affirm under penalty of perjury one offhe fallowing declarations:
I have: and will maintain a certificate of consent to self-fissure'for workers' compensation, :issued. by. the Director of Industrial Relations as provided for by Section 3700 of the tabor Code; for th
perforinanca of the work for which this permit is issued. Policy No.
I 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. hfy workers' compensabo
Nnsurance carver and policy number are:
Carrier Policy Number Expiration Date
Name of Agent. Phone #t
❑I 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 agre
trial, if I should beco s bject to the workers' compensation pro ions of Section 3700 of the Labor Code;. I --shall forthwith comply Win those provisions.
Signature of Applicant Dale,DECLARATION RE RDIN N ON LENDING AL +�
I hereby affirm under penalty of perjury'that there: is a;construction lending agencyfor the performance of the work forwhich this permit is issued (Section 3097, Civil Code)..
Lenders Name - Lenders Address
By my signature below, I certify to. each of the following:
I. am the property owner or authorized to act on the property owners behalf.
I have read this application and the information f have provided is Correct.
I agree to comply with all applicable city:noCO my dfnances and state laws relating to building construction,
( authorize representatives of this city or t➢inty ` ntet fit ove-fden fed grope for inspection purposes.
Si nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent S Name e
:ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE. USE. ONLY R�
REGULATIONS PART 61 OF TITLE 40 AND AOMO RULE
14W
PERA41T EAMR£O LJ III SSUUBBMMII•T-TED—AS•RESTO Ti FICATiON TO
PERMITCANCELLED- • Ell P e "♦ •�
PERMITEXFENDED • a • ♦ • -
QfaA•U, e. e
PERMITFINAL I /—2-3-L Amp,_ A BESTOS N011FICAT€ON 15 NOT APPLICABLE TO
C€RFIFICAi£OF �pw PROPOSED DEMOLITION.
OCCUPANCY ISSUED Dr51(iNAUAE:
�)_2
♦ a
♦ ♦ a +e e -
e e
•m♦ •ee ♦ee e e eoe en