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Home My WebLink AboutXR2023-0352 - PermitsaEWPOar City of Newport Beach D� @ Community Development Department- Building Division X R 2 0 2 3 0 3 5 2 COMB Permit : XR2023-0352 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 2922-2021 Permit Counter Phone: (949) 718-1888 Issued Date : 09/12/2024 newportbeachca.gov/civic Final Date: gAroaN� Combination Type - SFP ELEC MECH PLUM Permit Status: Issued Work Class - Alteration Inspection Area : 6 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 : 12 ANDIAMO Legal Desc : N TR 15337 BLK LOT 43 Description: SFR *ADDITIONAL SCOPE* REMODEL MASTER BATHROOM, BEDROOM AND CLOSET 900 SF, ADD 11 SF AT 1ST ENTRANCE Owner: TABOBZADEH RAMIN TR Contractor : LUIS DONAN Architect : NEHORN-TOME MITRA Address : 12 ANDIAMO Address : 3622 S OLIVE STREET Address : 132 S SPALDING DR#217 BEVERLY NEWPORT COAST, CA 92657 SANTA ANA, CA 92707 HILLS, CA 90212 Phone: Phone: (714)640-1706 Phone: (310)574-2656 Con State Lic : 885896 State Lic Lic Expire : 10/31/2024 Applicant: NEHORN-TOME MITRA Bus Lic : BT30085166 Engineer: FARHAD MANSHADI Address : 132 S SPALDING DR#217 Bus Lic Expire : 09/30/2025 Address : 1800 E 16TH ST UNIT B BEVERLY HILLS, CA 90212 SANTA ANA, CA 92701 Phone: (310) 574-2656 Workers' Compensation Insurance Phone; (657) 335-4112 Carrier : Owner/Builder: Policy No: EXEMPT Designer: Address : W. C. Expire: Address Phone: Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $150,000.00 Type of Construction : V-B Fire Hazard Zone : YES Added/New/TI sq. ft. Bldg : 11 Occupancy Groups : R-3 No of Units : 1 Alteration sq. ft. Bldg : 900 Bldg Height : No of Stories : 2 Add/New sq. ft. Garage: 0 TOTAL sq. ft.: 11 Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 10 Flood Zone : X Use Zone : PC - Newport Ridge PROCESSED BY: INSPECTOR SPECIAL CONDITIONS: REV2023-0232 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 checkmafk(s) I have placed next to the applicable items) 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 he 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 Drofessions 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 fora permit subjects the applicant to a civil penalty of lot 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 U portions of the work, and the structure is not intended or offered for sale (Section 70", 3uslness 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 mprovements 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 mproved for the purpose of sale). I, as owner of the properly, 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: 3y 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, 1 Cannot legally ;ell 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 Drofessions Code, is available upon request when this application is submitted or at the following Web site:hop:liwww.leginfo.ca.govlcalaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION 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 NORKERS' COMPENSATION DECLARATION NARNING: 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 15109,0001, IN ADDITION TO THE 'OST 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, 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 th1 aerformance of the work for which this permit is issued. Policy No. :1I 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' compensatior nsurance carrier and policy number are: Policy Number Expiration Date of Agent Phone R 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. nature of Applicant Date_ CLARATION REGARDING CONSTRUCTION LENDING AGENCY areby 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). lders Name Lender's Address my signature below, I certify to each of the following: to I am the property owner or authorized to act on the property owner's behalf.INSPECTOR I have read this application and the information I have provided is correct. � L I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. mature of Pmaertv Owner or Authorized Agent Print Prooertv Owner's or Authorized ADent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AID RULE "I'll' 1--I ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED //� SIGNATURE: