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Home My WebLink AboutXR2023-3437 - Permitswno City of Newport Beach III�I��II��I�IIII�III��IIIIII�IIIII� II Community Development Department Division COMB Permit : XR2023-3437 O i Y P P 9 X R 2 0 2 3 3 4 3 7 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 2922-2021 ? Permit Counter Phone: (949) 71 B-1888 Issued Date : 12/05/2023 newportbeachca.gov/civic Final Date: <�coaN� Combination Type - SFP ELEC PLUM Permit Status: Issued Work Class - Other 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 BILK LOT 43 Description: DELTA 3- GAS/ELEC FOR FIRE PIT & BBQ. BLOCK WALL (INSIDE P/L) 6' X 10' (CITY STANDARD) Owner: TABOBZADEH RAMIN TR Address : 12 ANDIAMO NEWPORT COAST, CA 92657 Phone: Applicant: TABOBZADEH RAMIN TR Address: 12 ANDIAMO NEWPORT COAST, CA 92657 Phone: Owner/Builder: TABOBZADEH RAMIN TR Address : 12 ANDIAMO NEWPORT COAST, CA 92657 Phone: Contractor Address : Phone: Can State Lie Lie Expire Bus Lie : Bus Lie Expire Workers' Compensation Insurance Carrier : Policy No: W. C. Expire: Architect Address Phone: State Lie Engineer: FARHAD MANSHADI Address : 1800 E 16TH ST UNIT B SANTA ANA, CA 92701 Phone : (657) 335-4112 Designer Address Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : Type of Construction : V-B Fire Hazard Zone : YES Added/New/TI sq. ft. Bldg Occupancy Groups : U 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 V- e � PROCESSED 8Y t�'It a SPECIAL CONDITIONS: $5,000.00 0 0 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items) ution 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 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 Businoss and fessions Code) or that he or she is exempt from )!censure 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L.) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, mass 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 rovements are not Intended or offered for sale. It, 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 roved 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' Slate License Law does not fyx(o an D'Amerof property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law), ::;�, i a exempt from Ncensure under the Contractors' State L -- e L w r the t Ilcwt ea n. 3y m • signature below t acknowledge that, except for my pe oral si rice in w is must ave resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally a structure that I have built as an owner -builder if it has t ¢n nstmeto itV(On6ir by Nc¢nsod cantractors. I understand that a copy of th¢ applicable law, Section 704A of the Businoss and 'rofessions Code, is available upon request when !h' applir on is ubmill: at ting Web site:htip://www.leginto.ca.gov/calave.html. Signature of Property Owner or Authorized Age _ Date)( 2��j �3.._ _ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provi. Ions of • er 9 (commencing with Section 7000) of Division 3of the Business and Professions Code, and my license is in full farce and effect. License Class License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION DARNING: 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 ($100,000), 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: 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 Ierrormance 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' compeosatior isurance carrier and policy number are: ;arner Policy Number Expiration Date 63rn f Agent Phone # �I ce Ify that, in the performanc - war or whic this mit is ),sued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws Of California, and agre, hat, ' I should become subject to orker comp sa n provisi s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I �1 J signature of Applicant Dale —{, ` / / 2 )£CLARATIGN REGA .....G N T h I' EN. ING A NGY hereby affirm under penalty ury lh t a is a const ictlon lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code). .ender's Name Lender's Address 3y my signature below. I certify to each of the following: I ant the property owner or authorized to sot 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 ordi a s no laws _ ` g to building construction. I authorize representatives of this city or county to ant a ab -iden 1 prop for inspection purposes. 3i nature of Property Owner or Authorized Agent Print Pro p ert Owner's or Authorized Agent's Nam U 1 S � h uDate 3 ACTION DATE BY [fECClAATION,COM LI CE U19TN CODE OK FEDERAL FOR OFFICE USE ONLY REGUWTIONS PARY 6t F TITLE 40 AND ACIMD RULE 1403 PERMIT. EXPIRED _ w I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CAIyCE!!ED _L]cPA --� PERMIT EXTENDED r QMD PERMIT F{NAL j ASBESTOS NOnncATION IS NOTAPPLiCABL£ TO CER OFICATE OE •Z&- I PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: __