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HomeMy WebLinkAboutX2022-0094 - PermitsCity of Newport Beach - Building Division IIII'IIIIIIIIIIIIIIIIIIIIIIIIIII�llll'I� II 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 0 0 9 4 Permit Counter Phone (949)644-3288 U. Inspection Requests Phone (949)644-3255 `xrPra�'` Combination Type - SFP MECH ELEC PLUM GRAD PERM EXMR6$ M0 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUS.r BE COMP! COMB Permit: X2022-0094 Project No : 0110-2022 Issued Date : 06/24/2022 Jawection Area : 6 ' Co trucTion Hbli urday f?6rM$18ti i .L4&6:00 p.m. No work on Job Address: 3 VISTA AL RI NB Description: SFR ADD 10 1 SF _ DEL a 80% or I0 .I 0 Legal Desc.: N TR 14070 OT 5 00 l0 refund HATA JEF s'"` r�,,tor Rji3 g f4schitect: Address: 3 VISTA ALB RI ` A rgt. 0_ � r `" ''� to who krill NEWPORT CAST CA 92657 Phone: 9 Milli -_p, Frh 78 Phone' Applicant: MEHOIZADI Address: 145 COTTO IRVINE, CA Phone: 949-554-7901 Code Edit Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage No of Stories: No of Units Bldg Height: Bldg Sprinklers: Flood Zone: II Construction Valuation: 9 0 Note: Building Permit Fee: $3,990.00 Plan Check Fee: $3,044.11 Overtime Plan Ck: $0.00 Investigation Fee:. $0.00 Record Management: $70.00 Energy Compliance: $185.63 CA Seismic Safety: $34.47 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $11.00 PROCESSED BY: LPG HA Co '� 1 lc - ;re = `- '�" : ''e�;.� Engineer: MEHOIZADEHNAE Address: 145 COTTONWOC us ic: IRVINE, CA 92618 Lic Exp Date: Phone: 949-554-7900 TOTAL FEE : $11,581.00 ZONING APPROVAL: Worker's Compensation Insurance Designer: r r Addres e �P.� r [empire: ` = u' �Pliod 0 dan uilr7mNetbacks Rear: 0 (no work sWe&raonditions: O/BA1 Front: 10 Left: 0 Additional Fee : Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: $0.00 $0.00 $0.00 $237.00 $199.00 $0.00 $279.30 $159.60 $359.10 Plan Check Fee [0 Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PNI Plan Check : $50.75 San Dist: $0.00 NMUSD Fee: $1,897.04 'LL Lit: IN VALIU or Holidays INa e Lic: ••oo ° )I MOHAMMAD ° a Li¢C-085373 ° a• • ° • o0 OUIi• • mo 0 0 • .• $208.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $27.00 General Service $265.00 Refund Deposit $564.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $11,581.00 PUBLIC WORKS APPROVAL: V f IJAa12[9:Ix9:tcYa GRADING APPROVAL: APPROVAL TO ISSUE: V 43f10 �Vuo 0 o�000 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 item(s) ction 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 _ _. licensed_ ursuant to the rovisions of the Contractors' State License Law Cha ter 9 co cing with Section 7000) of Division 3 of the Business and fessions Cone) or that he or she is exempt from licensure an a asls or me allegeallegea exemption. Any violation Or ec Ion 70 . - y any appli nt for a permit subjects the applicant to a civ,, penalty of iot more than &a hundred dollars i Z dollars woo). �_,Z,1 � 1 s ownerg)f thePwapeeor my employees with wages as their sole compensation will do (1 I caf Q,P @fflo' @f the work, and the struct uslness and ofessions Code: The Contractors' State License Law does not apply to an ownerr o�roperty who, through employees' or personal '.mprovements re not intended or offered for sale. If, however, the buildin or improvement is sold wHhlr�o�{eoyear of peq�pJebgg4d a Owper-Buu de, 'mproved for tha I r s �-"• tifh% - LJ6U/0 ©I rT liiJ �o r9 I, as owner f th roperty, ex vely con cg Contrac" o ruct the project (Section 7044, Business and Professio apply to an owrEer of ,roperty buil r I r4e ont t r the pE acts wit Iqe sgd, optractor pursuant to the Contrac I am exam fro t nder thhee�ractors�5- La the g`�: � U . By my signatur below I ackn ledge that, except for my personal residence in which I must have resided for at least one year prior to completion c sell a structure hat I s an __,r,amg� r if be c to n y licensed contractors. I understand that a copy of 1 Professions C e, is e" on resTwh l3 a s f Web site:http://www.le info.ca.gov/calaw.html. Signature of Pr eIt o Litho LICENSED Wi • DE y 1'}lergbyaffirm ntl®r " erjury a am�llCense under provislo s o h (CD encing with Section 7000) of Division 3 of the Busim dhd effect. Li 0.gAs License No Date Contractc 4(0AKERS' ONIPENSATION DECLARATION ISARNIFI�i: FAILU _ Tp OR ' COMPENSATION COVERFE IS UNLAWFUL, AND SHA CT RLOYER TO CRIMINAL PEI�FLLTIEs A CIVIL FINES UP TO COSTA&FAILE TIO ,DqM ES ry TIONCOCER 37 �1LABORCODE,I E - Nr•AA NEER � %ereby affirm �a • • of Che�follg�t�ns: 4a, 3 3 ••PR2v and ill I fain a ce(t{�c�a�e�pf t-tq�seIf-insure for workers' com ensatip s b h Industrial Relations as e work ER S Rid N ��is�eH. Pbrcy No. P \ kF v. t JC}felMAV.e a O he work a ch It`YS' i s avrs and III ails In workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work T%urance cars f 4 y number are: ^�4deY: Policy Number Expiration C is not intended or offered for sale (Section 7044, fort,: builds or improves the property, provided that the will (rave the burden of proving that it was not built or s Code: The Contractors' State License Law does not ITS' State License Law). law, SectionA7044 of the and' Professions Code, antl my license is in full force HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE for by Section 3700 of the Labor Code, for this permit is issued. My workers' certifythat,§ ,dheaAetlnfma �P of rhP wo h h th'c penni ' Is ad_ I shall not am to an arson in an manrLer �o e o le o the workers' com ensation laws of CalI orm , and a re 4� P 9 t, if I should becomesu(bJ/ect—to the workers c pensation rovisionsectlo{6ni00 o t�e a or�oesha,with comply with those provisions. nature of Applicant 1 X \ �C,Z _ Date `T CLARATION REGAWDD I�TRUCTION LENDING AGENCY arby affirm under penalty of perjuiry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider's Name Lender's Address 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. q I have read this application and the information I have provided is correct. I agree to comply with all applicable city and coun ordinances and state laws relating to building construction. �J 1 I authorize representatives of this city or cou t r i bove-identi d roperty for inp ' urposes. mature of Prooertv Owner or Authorize) Aoent \ c Print Property Own prized Agent's Nam Date ACTION DATE I BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED JA_217Z iSUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMITEXTENDED _ AQMD PERMITFINAL Y'ASBESTPI NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE MON ANCYED SIGNATUR Cj6FT OCCUPI SU) A A