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Home My WebLink AboutX2020-1759 - PermitsCity of Newport Beach - Building Division �c 100 Civic Center Drive, Newport Beach, CA 92660 H Permit Counter Phone (949)644-3288 - Inspection Requests Phone (949)644-3255 Combination Type - BLDG IIY��Iu�IIII�2�l��lull��lllll COMB oe1 mt: X 020-1759 Issued Date: 1010112020 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 10/02/2023 OR PERMIT WILL BE INVALID Construction Hours: Monday - Friday 7.00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 4500 ROXBURY RD NB Description: SFR 12 CAISSONS FOR SWIMMING POOL (52020-0113) Legal Desc.: N TR 3357 LOT 11 - Owner: ROWSHAN KASRA Contractor: GABAY DAVID JOHN JR Address: 4500 ROXBURY RD Address: 31726 RANCHO VIEJO RD CORONA DEL MAR, CA 92626 SAN JUAN CAP CA 92675 Phone: Phone: 949-370-0478 Applicant: SMITH RICK Con State Lie: 529750 Address: Lie Expire: 06/30/2022 Bus Lie: BT30033857 Phone: 714-955-8786 Lie Exp Date: 12131/2020 Code Edit: 2019 Workers Compensation Insurance Type of Construction: Carrier. CALIFORNIA INSURANCE Occupancy Group: U Policy No: 468264410 Added /New sq.ft. Bldg: 0 Expire: 04/01/2021 Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / No of Units, 0 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: I Flood Zone: I Ice 7nnw- P.M.. Rnaccc'-- n Building Permit Fee: $1,209.00 Plan Check Fee: $1,051.83 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee: $4.00 TOTAL FEE: $3,208.83 PROCESSED BY: ✓t J ZONING APPROVAL: Q GRADING APPROVAL: S Architect Address: Phone: State Lie Engineer: DEIHIMI DAMIR HOSSEIN Address: 23172 PLAZA POINTE DR STE 145 LAGUNA HILLS CA 92653 Phone: 949-954-7244 State Lic:C-078194 Designer: Address: Phone: Special Conditions: S2020-0113 Excise Tax: $0.00 Planning Department - Additional Fee: $0.00 Plan check Fee: Grading Bonds Fee: $0.00 Fair Share : Grading PC Consultant: $774.03 SJH Trans: Grading Permit Fee: $0.00 In -lieu Housing Fee Grading PC Fee: $169.92 Public Works Department - WO Insp. Fee: $0.00 Park Dedication: $0.00 PM Plan Check: $0.00 Electrical W $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbing %: $0.00 Fire Department $0,00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee : $1,742.43 Fee Due at Permit Issuance : $1,466.40 PUBLIC WOjq* APPROVAL: o 0 • o 0 0 •• • ® • s ®•VIA PLAN CHECK BY: ° ' ° APPROVAL TO,ISSUE,:, 0 0 0 0 0• o -o- s o 0 0 0 I hereby atfum under penalty of perjury that I am exempt from the Contractors' State License Law for the mason(s) indicated below by the checkmark(s) I have placed next to the applicabie item(s) 'Section 7031.5, Business and Professions Code: Any city or county that requires a permit to conshu01, alter. improve, demolish, or repair any structure, prior to its issuance, also requires the applicantfor be permit to file a si jned 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 ficenstue and the basis for the alleged exemption.. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a CM penalty of rot more than five hundred dollars ($500). ],as ovmer 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, 3usjness end P re m t irateons Code: The Contractors' Sale. If, License Lew does not apply a an owner of VOID on who. through employees' or personal effort, builds or Improves the property, provided that the mprovemems are nut se of safe). ). 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 itwas not built or mproved forthe purpose of sale). I, as Owner of thr: property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ipply to an owner of property who builds or improves thereon, and who contracts for the projects me a licensed Contractor pursuant to the Contractors' State license Law). 1 am exempt from licensors under the Contractors' State License Law for the following reason: ly my signature beicw 1 acknowledge that, except for my personal residence in which I must have resided farZo: at feast one year prior tO 1 JAMIon ofthe improvements covered by this permit, I cannot I gall a structure that I have built as an ownerbuilder if it has not been constructed In its entirety by licensed contractors. I understand that a coof the egalt 'rofessions Code, is available upon request when this application is Submitted or at the following Web site:http://vAwi leginfo.ca.govlcalaw_hhr�d. ��I�le law, Section 70g4 ofthe Business and Signature Of Properfi: Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION Date hereby aifirrn under penalty of perjury that I am licensed under provisions or Chapter 9 (commencing with Section 7000) of Division 3 of the Business rotes ons Code, and rrry license is'in hill force nd effect. joense Class License No SZ�� % SLR Date l? -" (Gontractor-Mgn WORKERS' COMPENSATION DECLARATION rgRNINe: FAILURE TO 5:_LTIRE WORKERS' COMPFNSgT10N COVERAGE IS UNLAWFUL. AND SHALL.SU13JWT AN EMPLOYER TO CROUNAL PEIIALT1E9 AND CML FWEs UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), Ur AoOnmON TO THE can' OF COMPENSAM"' DAMAGES AS PROvmEO FOR W SECTION Tre6 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FPS. hereby affirm under penalty of perjury one of the following declarations: mI 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 tabor Code, to rmance of the work for which this permit is issued. Policy No. ve and will mc.intain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this pert is issued. My workers' on as race carrier and policy renumber ale: rier Policy Number ne of A..f 6g71Tati0n Data certify that, in the pedomn nee -oft a 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 L If I should becom eeFto- orkers' compensation provisions of Section 3700 of the Labor Code, I shag forthwith comply with those provisions. nature of� �c-M�✓e-G_ ,,gyp Dated/ l` "` ' •��'1 CLARATION REG G CONSTRUCTION IN NGY �.� neby affirm under penalty of pequrythatthere is a construction lending agency for the performance ofthe work for which this permit is issued (Section 3097, Civil Code). ide's Name Lender's Address my signature below, I certly lu each of the following: - i am the property owner or authorized to act on the property Owners behalf. 1 have read this soplication and the information I have provded is correct I agree to comply with all applicable c armd court ,o>dinan and state laws relating to building construction. I authorize representatives of this city or count�.t an 6 ,M_ pe=ide ed property for inspection purposes. DATE I By PERMITCANCELLF r} ❑ )SU 11— ASEESTOS NOTIFICATION TO: ❑ EPA P8iPd7TEICfEN11E1 • • • . • . • • [3 AQMD ❑ ASSESTDSNOUFfCAT10NISNOTADPLICAB_ETO PERA,U]MMAL • • • • • . • . . PP.OPOSEDDEMOU170M CERTIFICATEOF OCCUPANCfWLi. D a' IC! iY/ / SIGfMATURE: m e F F e s e• e • o o e • ee om o e • o o c o eoo mo 00 0 o cac cc