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Home My WebLink AboutXR2023-1262 - PermitsU City of Newport BeachCOMB Permit:XR2O23-1262 Community Development Department- Building Division X R 2 0 2 3 1 2 6 2100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No Permit Counter Phone: (949) 718-1888 Issued Date : 05/15/2023 newportbeachca.gov/civic Inspection Area : 6 Combination Type - SFP Work Class - Other 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: 14 ANDIAMO Description: SFR R/R DRYWALL 500 SF Owner: BOROUKHIM SILVANA TR Address : 14 ANDIAMO NEWPORT COAST, CA 92657 Phone: (714)915-7272 Applicant: MOMO DESIGN GROUP INC Address : 30 EDELMAN IRVINE, CA 92618 Phone: (949)874-2433 Owner/Builder : Address : Legal Desc : N TR 15337 BLK LOT 42 Contractor: MOMO DESIGN GROUP INC Address : 30 EDELMAN IRVINE, CA 92618 Phone: (949)874-2433 Con State Lic : 1037903 Lic Expire : 04/30/2024 Bus Lic: BT30081557 Bus Lic Expire : 05/31/2024 Workers' Compensation Insurance Carrier: STATE COMPENSATION INSURANCE FUND Policy No : 9308660 W. C. Expire : 11/12/2023 Architect Address Phone: State Lic Engineer: Address Phone: Designer: Address : Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation Type of Construction : V-B Fire Hazard Zone : YES Added/New/Tl sq. ft. Bldg Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height : No of Stories : 2 Added/New sq. ft. Garage: TOTAL sq. ft. Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 10 Flood Zone : X Use Zone : PC - Newport Ridge PROCESSED BY: SPECIAL CONDITIONS: 00 $8,00h.00 " 0 0 0 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 flem(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 ro permit to file a signed statement that lie or she is licensed pursuant to the previsions of the -Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofesswris 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 of more than five hundred dollars ($500), 1 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 70", 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 nprovements are not intended or offered for sale. If.,. however, the building or improvement is sold within ono year of completion, the Owner-Sutlder will have the burden of proving that it was not limit or n^tproved for the purpose of sale}. ,J I, 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 ply to an owner of property who builds or improves thereon; and who contacts for the projects with a licensed Contractor pursuant to the Contractors' State License Law), I am exempt from UUenaure under the Contractors' State License Low for the following reason' _ ly 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 bythis permit, I cannot legally all a structure that I have built as an owner-buildor 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 Yofessions Code, is available upon request when this application is submitted or at the following Web site:http:llwvw.isginfo.ee.govtcataw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0 of isio% 3 of the Business and Profess! •Coe d Ce •a s )n full force nd effect. License Class License No Date 2 Contractor Signature VORKERS' COMPENSATION DECLARATION DARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER to CRUMNIAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS J4400,000), IN ADDITION TO THE DST OF COMPENSATION OAMADES AS PROVIDED FOR IN SECTION 3709 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, I hereby affirm under, petelty of perjury am of the fallowing declarations; 13, 1 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 in pe r ❑name of the work fir which this permit is issued. Policy No nave 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. luny workers' eompansatior ins.rranw carrier and policy number are! Can or Policy Number Expiration Date Name ut Agent _ Phone 9 [3I aertity that, in the nPnarmanCa of the work f - whi"ispet is issued, f shell not employ any persanin any manner sD as to become subject tothe workers'compensation laws ofG8ltfomia, and agrethat, ii I should become su ct to th w rkar • •ompe➢sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.�� Signature of Applloant"„ _ Data: / DECLARATION RErARIA O. O 6TR. TION LENOCNO AGENCY I I teraby affirm under penalty 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). Londe( s Name Lenders Address By my signature below, I certify to each of the fallowing: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to Comply with all applicable city and County ordinances a. tate w relating to building construction. I authorize representatives of this city or county - ter ad roperty far inspection purposes. Signature of Property Owner or Authorized.Agent Print Pro art 4wnar's ar Authorized A ent's Nama '�(• Q Date ACTION DATE By DECLARAIDONOFCOMPUANCE. WITH CODE OF FEDERAL FOR OFFICE USE ONLY ' REGULATIONS PART 61 OF TITLE 40 AND AQMO RULE 403 FEftM7T EHt£NREb _ OMD PERINAt— ------ SMSTTISN611HCATION SNO LIC MIP PABLE TO CEftTlFIGAPE OF . —Ib-2S E)pk PROPOSED OEM IT StGNATIIRE: OCCUPANCY 6SUEb i