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Home My WebLink AboutX2021-2355 - PermitsOwner: MEDALI REZA Address: M36 E ABBEY LN ORANGE, CA 92867 Phone: 626-485-8277 Applicant: HAJIALI AHMAD Address: 701 S RAYMOND AVE #1 FULLERTON, CA 92841 Phone: 949-637.2271 Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3 Added /New sq.ft. Bldg: 144 Added/New sq. ft. Garage: 0 No of Stories: 2 No of Units : 2 Bldg Height: 0 Bldg Sprinklers: Building Permit Fee: $1,447.00 Plan Check Fee: $1,258.89 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $0.00 Energy Compliance: $93.90 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $6.00 TOTAL FEE: $3,145.94 City of Newport Beach - Building Division �! 100 Civic Center Drive, Newport Beach, CA 92660 'v Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 °ream;> Combination Type - MFP ELEC MECH PLUM PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and C Job Address: 438 1/2 GOLDENROD AVE NB Description: MFR REMODEL (438.5) REAR UNIT 1,359 SF t4 C® Legal Desc.: CORONA DEL MAR BLK 434 LOT 22 OWNERIBLDR `n'EEK �: MEDALI -rH V�tAddress: 3136 E AN ORANGE CA 92867 626-485-8277 Phone: Contractor Address: Phone Con State Lic: Lie Expire: Bus Lie: Lie Exp Date: O/B Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee : Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / COMB Permit: X2021-2355 Project No : 2036-2021 Issued Date : 12/01/2021 Inspection Area : 5 N2 BY 12/01/2024 OR PERMIT WILL BE INVALID p.m. No work on Sundays or Holidays State Lie: Engineer: ZAKERI BEHZAD Address: 13628 FREEPORT RD SAN DIEGO CA 92129 Phone: 714-600-0182 State Lic:C-089670 Designer: Address: Phone: Special Conditions: Fire $0.00 Planning Department - Fire Department $0.00 Plan check Fee : $0.00 Fire Inspection: $0.00 $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 $0.00 SJH Trans : $0.00 Demolition Fee $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 $0.00 Public Works Department- General Service $0.00 $0.00 Park Dedication : $0.00 Refund Deposit $0.00 PAN Plan Check: $50.75 Grading Bond: $0.00 $101.29 San Dist : $0.00 $57.88 NMUSD Fee: $0.00 $0.00 $130.23 $0.00 Plan Check Fee : $2,117.82 Fee Due at Permit Issuance : $1,028.12 PROCESSED BY: `(�(; __ PUULIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: _ _ '-APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 ie 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 'rofessions 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). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 one year of completion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). 1, s 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 p 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). I In exempt from licensure under the Contractors' State License Law for the following reason: ly m signature below I acknowledge that, except for my personal residence i which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally structure that I have built as an owner -builder if it has not been onstru ad i is entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request wh t IS ap n s mi d or t the following Web site:http://www.leginfo.ca.gov/calaw.html. Iignature of Property Owner or Authorized Agent D 142 �G .ICENSED CONTRACTOR'S DECLARA 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 Cod and my license is in full force nd effect. License Class License No Date Contractor Signature CORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000I, IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 thi erformance of the work for which this permit is issued. Policy No. 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. My workers' rance carrier and policy number are: Policy Number Agent Date ilY rtify that, in the performance of the work for which th s 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 ag re lat, I should becomesubject the orke s' omp nsa on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro visions. ign tura of Applicant Date LARATION REGA C NSTRUCTI L NDI G AGENCY hereby affirm under p nalt of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ender's Name Lender's Address y 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 county ordinances a d state la relating to building construction. I authorize representatives of this city or county to en b -de tifie roperty for inspection purposes. ignature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name �x ✓ ate ACTION DATE BY ECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY EGULATION5 PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED 0 1 SUBMITTED ASBESTOS NOTI FICATICN TO PERMITCANCELLED UEPA - - PERMIT EXTENDED MD PERMITFINAL "BE (CATION IS NOT APPICERTIFICATE CAB�TO OCCUPANCYISSUED � �i%� POSED�E(yIOLJ,TjIO �/�g��OP SIG NATOR E: