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Home My WebLink AboutXR2022-2143 - PermitsSEW PO/iT City of Newport Beach jai 111p111111111111111111111111111111111p11111111111111 COMB Permit : XR2o22-2143 Community Development Department- Building Division �y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: 2036-2021 V = Permit Counter Phone: (949) 718-1888 Issued Date : 08/10/2022 ae. newportbeachca.gov/civic Final Date: C9l/FORRaP Combination Type - MFP Permit Status: Expired Work Class - Other Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION ,I WEQ QL% On c�TLtR nnR,SUNDAY<,-4N-HW.M n)ENSt - RE- 'S A*D,NO.W(3RKCN y N r=A"OLIDAYS IN ALL AREAS Job Address: 438 GOLDI Description : DELTA D - AVE Legal Desc A TR CORONA DEL MAR 4,,J-012 ,ems, W. Owner : GHOLAMREZA � ED Ll Address : 3136 E ABBEY LN ORANGE, CA 9867 Phone: / t Applicant: BEN BACHELIEIR -A Address : 4871 EL MOLINA AVE RIVERSIDE AVE, CA 92504 G WALL 1.2"-24" X 79" IeRj3 C Contractor: BEN:BACHELIERO Architect: - Address : 4871 EL MOLINA AVE= Address RIVERSIDE AVE CA92504 r rPhone : (951-) 712-3209 Phone: Con State Lic : 777589 State Lic Lic Expire : 04/30/2024 L•- - BusLic : BT30079 Engineer: ZAKERI Bus Lic Expire : 11/30/2022 Address : 13628 F Phone : (951) 712-3209 „ Workers' Compensation dnsurance Carrier: CLEAR SPOG PROPERTY Owner/Builder. Policy Na: CWC009Z5Z00 Address W. C. Ex Ire : 7/11/2023 P \ Phone Code Edition : 2019 Type of Construction : V-B Occupancy Groups: U Bldg Height: 1 :.✓ Ei3. Building Setbacks : Front: 15, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone: R-2 - Two -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: Fire Hazard Zone No of Units : No of Stories -i NO 0 SAN DIE Phone: (714)6C Designer: ° 2 Address Phone: �- HZAD =PORT RD I, CA 92129 182 $5,000.00 a: 0 Alteration sq. ft, t3idg € Added/New sq. ft. Garage: 0 TOTAL sq. ft. : 0 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 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 the 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 Professions 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 not 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 7044, Business 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 improvements 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 improved For the purpose of sale). LJ I, as owner of the property, am e; apply to an owner of property who bu ❑ 1 am exempt from licensure unde By my signature below I acknowledge sell a structure that I have built as an ,Professions Code, is available upon I ,Signature of Property Owner or Auth, (LICENSED CONTRACTOR'S DI I hereby affirm under penalty of perju Wand effect. License Class WORKERS' COMPENSATION E WARNING: FAILURE TO SECURE WORKERS COST OF COMPENSATION, DAMAGES AS PR hereby affirm under penalty of perju ❑ 1 have and will maintain a certifi performance of the work for which thi ❑1 have and will maintain workers' insurance carrier and policy number I ne of Agent certify that, in the performance , if I should become subject to I ;ively contracting with lfcen-_ d Contraclors to construcf fK6 project"(Section 7044, Business and Professions Code: -The -Contractors' State License Law does not or improves thereon, nd o r c fs/,rh, p ' is with a licensed Contractor pursuant to the Contractors' State License Law). Contractors' Stale L e Be a F vmg earson.- IL oxcept for my pars iresidence ii whicht rtiL si"fiavve-Maone year prior -to completion of the improvements covered by this permit, I cannot legs ter -builder if it has not b en constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Sect�n 70" of the Business and es(, -When this application is submitted or at the following Web sile:http�fiwww.leginfp.de.gov/,alaw.htmi. n onrinel -� that am licensed under: provisions of Chapter 9-(commencing with Section 7000) of`DwnaQ ri3mf the Business and Professions - License No - Date Con rac or Ign Uure — OMPElfSATi N VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THE IIDED ¢OR CTION ]Ir. OF THE. LABOR CODE, INTEREST AND ATTORNEYS FEES one f f wing declarations ate ot"Whisent`to self -insure for vmrkers' compensation, issued by the Director of Industrial Relations as provided for by permit is issued. Policy No. insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit work for which di"t%4886e3efr all not employ any person in any �a;•oltt-{b" Lso t to the workers' rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those previsions. nature of Applicant ___ CLARATION REGARDING CON RUCTION L ereby affirm under penalty of perju that there is a construction lending agency for the performance of the work for which this Ides s Name ddress my signature below, I certify to ea 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 and stale laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. nature of Prooertv Owner or Authorized Aaent Print Pronery Owner's or Authorb DATE ( BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 51 OF TITLE 40, AQMO RULE PERMIT EXTENDED _ _ LJAQMO ❑ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO PERMITFINAL CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: Is and my license is in full force LARS (SI00,000), IN ADDITION TO THE ;70p of the Labor Code, for the uerl; My workers' compensation ipq;laws of California, and agree