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HomeMy WebLinkAboutX2021-3407 - PermitsCity of Newport Beach - Building Division *X2021-34Q,7,1` o' O 100 Civic Center Drive, Newport Beach, CA 92660 " Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 a- T Combination Type - MFP PLUM I i "c7 P E QTOF1SP' Y llr• y:. n�.Ne PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALI SPECTIT`PROJEC;S,MUST 1 Construction Hours: Monday - Friday 7:00 a.m. t :30 p.m. p atu!morom 8:0000 Job 757 Descripdtions. MFR SOTOP WORK* DRYWALL REPAIR AND PLUME KITCHEN O CADO AVE NB Legal Desc.: TR 10274 LOT 1 UNIT 205 OF PROJECT LOCATED AP 50-323-1!1.3'fOGETHER� Owner: CAREY ZETOUN Address: 2999 E OCEAN BLVD #620 LONG BEACH, CA 90803 Phone: ^� OWNER/BLDR .� KARAM DELILAH - Ole FORM ATTACHED 805-402-1070 Applicant: KARAM DELILAH Address: 4353 BROO KLYN ST. _.-: 'L. .}b� Gon State Lic: �:Lic.ExpIre: OIB MOORPARK, CA 93021 ��,, Bus Lie s Phone: 805-402-1070 Lic Exp Date: Code Edit : Type of Construction:: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Gars No of Stories: No of Units : Bldg Height: Bldg Sprinklers: Valuation: 201vY F / R r� e: 3` 24 0 X: Building Permit Fee: $127.00, Plan Check Fee: $110.49 Overtime Plan Ck: $0.00 Investigation Fee: $127.00 Record Management: $12.00 - Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $440.92 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: cC Worker's Compensation Insurance Carrier Policy No a Expire mg 5efbacks 1"r,6w" Rear / Front I F;e ,Left I `• -Right l` 4ETED BY 1 Z 6:00 p.m. No Architect: Address: Phone: ®� Statc Engineer\b MEHDIAB ADI SA; Addre� 38 HENDRIX ST I�NECA92614 � h33-7927 State ` De ns: Ns "F Phone: `�®t`� Sp al C010%• - 477 COMB Permit: X2021-340 Project No : 2974-2021 Issued Date : 1212012021 Inspection Area/L, 4 OR PERMIT WILL BE INV, on Sundays or Holidays d Excise TaRm b.00 tannin ep ent- Fire Department Ad "on r�5 .00 PI ch ee : $52.00 Fire Inspection: B s��� $0.00 air are : $0.00 Fire Plan Rev ra C C l9Rant' $ Trans : $0.00 Demolition Fee g Per F 0.00 In -lieu Housing Fee : $0.00 Building Dept Adm grading PC Fee: $0.00 Public Works Department- General Service WQ Insp. Fee: $ 0 Park Dedication : $0.00 Refund Deposit e. PAN Plan Check: $0.00 Grading Bond: tr" .00 San Dist: $0.00 Me a ical %: $0.00 NMUSD Fee: $0.00 lum 1' $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $440.92 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: k OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law a yeas( (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to co ct, alter, i the permit to file a signed statement that he or she is licensed pursuant to the provisions of ontractor '� X. Professions Code) or that he or she is exempt from licensure and the basis for the alle_ xemption. *A latic tnot more than five hundred dollars ($500). Q,O y..r I, as owner of the property, or my employees with wages as their sole cc nsation, will U all of �i1 J'po Business and Professions Code: The Contractors' State License Law do ' not apply to a ner of prope y who, improvements are not intended or offered for sale. If, however, the-d ing or impro Ent is sol(twithin one yea improved for the purpose of sale). K) d !rk, A Zdy the checkma\inte e placed next to the applicable item(s) Eandthe any str rits issuance, also requires the applicant for (co encinction 7000) of Division 3 of the Business and applicant it subjects the applicant to a civil penalty of structure ised or offered for sale (Section 7044, )loyees' or personal effo'reproves the property, provided that the on, the Owner -Builder wie rden of proving that it was not built or ❑ I, as owner,of t:rrp,operty, am exclusively contracti ith licAr> Factors to construct the projee�(Section 7044, Business and Professions Cade: The Con pply to,an owner of property who builds or improv ereon, aaontracts foi'& projects with a licensed Contractor pursuant to the Contractors' State Licensi iJ I an, exempt from (:censure under the Co ctorst�f LI se Law for the following reason: % mysignature below I acknowledge th xcl fo rr y onal residence in which I.must have resided for at least one year prior to completiofVictvle emen ^ell a -fructure that have built as a ner-builder if' as not been constructed In Its entirety by licensed contractors. understand that a c y law, Professions Cody, is a':ailable request whe this a Ilcabon is srbMittel or al the to Web site http //www.leginfo.ca.gov/cola I. Gignatu.e of Property Ow r Authori7i; _ hereb}- affirm under Dena of p%gLTry that mo e)rect. License Class VORRERS' CZPF.NSA ON , LARA ARMING: FAILURE TO SECURE WOR Rs CQjv1PENSAI 0.:1 CF COMPENSATION, DAMAGES A PROV ED FOR hereby affirm under psnalty`oi pe ry one of tl I have and will maintain a certl ate of cc erformance of the work for which this ernri 11 have and will maintain workers' co ensa Isurance carrier and policy number ere: .. ne of Agent 's certify that, in the performance of the work I, if I should become subject to the work rs' nature of Applicant x n licensed under provisions of Chapter 9 (commencing'with Section 7000) of DiViisiol of N3'fness and License No Datey�ractor Signal 'ION '�'c )N :COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER T RIMINAL PENAe" AND CIVIL FINES UP ONE t1flM SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEE �` ' following declarations:. 5 ,XI senf to self insure for workers' col ITSn,�ssued by the Director of Ind nal RelatNAis a vid( asupd: Policy No. x � Y as required by Policy Number_ ireby affirm under penalty of perjury that there is a �� Ider's Name my signature below, I certify to each of the following: '11 I am the property owner or authorized to act on the pry I have read this application and the information I have I agree to comply with all applicable city and county of I authorize representatives of this city or county tg-ent nature of Prooertv Owner or Authorized Accent �� ACTION PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED is State License Law does not his permit, I cannot of the Business and / 'O ./ 7�� U license is in full force DOLLARS F$100,000), IN ADDITION TO THE for by Section 3700 of the Labor Code, for Labor Code, fo a perform e e work for which this permit is issued. My workers' Expiration Date Phone # SIT all9 em 4 any pers a In anner so as to become subject to the workers' compensation laws of California, and agree ;tio 70 the Labo od all to comply with those provisions. Date , a- Imo/ 2 j 9cy f e ormance of the work for which this permit is issued (Section 3097, Civil Code). er's Address state laws relating to building construction. �entifie�,pr.�party or a bn purposes. 5� \\ 11 Print Prooertv Owner's or Authorized DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBESTOS PROPOSED13 SIGNATURE: NOTIFICATION IS NOT APPLICABLE TO FOR OFFICE USE ONLY Name Rff l"Dae fi� 4Ty r. 6 0 �aa�"