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Home My WebLink AboutX2020-2170 - PermitsCity of Newport Beach -Building Division 100�Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 y* Inspection Requests Phone (949)644-3255 Combination Type - BLDG COMB Permit: X2020-2170 IIP�X 2 0 2 0 2 1 7 0II Project No : 1748-2020 Issued Date : 10107/2020 Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VAUD INSPECTION. PROJECTS MUST BE COMPLETED BY 10/08/2023 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: 11105W BALBOA BLVD NB Description: DEMO DETACHED GARAGE 240 SF Legal Desc.: N TR 234 BLK 11 LOT 23 Owner: HAI TRINH Contractor: T M WRECKING & EXCAVATING Architect: $0.00 Address: 12305 PROVINCETOWN ST Address: 15730 WINTERS LANE Address: $0.00 Hazardous Mat SEAL BEACH, CA 90740 Building Green Fee : RIVERSIDE CA 92504 $0.00 NMUSD Fee: Phone: Phone: 951-776-2056 Phone: Applicant: MEDRANO TOMMY Con State Lic: 392016 Engineer: PHAM LAN NGOC Address: 15730 WINTRS LN Lie Expire: 07/31/2022 Address: 14645 SERON AVE RIVERSIDE, CA 92504 Bus Lie: BT30072143 IRVINE CA 92714 Phone: 951-776-2056 Lie Exp Date: 1013112021 Phone: 949-735-9086 Code Edit: 2019 Type of Construction: VB Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Building Permit Fee: $120.00 Plan Check Fee: $0.00 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 : $1.00 TOTAL FEE: $121.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Workers Compensation Insurance Carrier: STAE FUND Policy No: 0703500 Expire: 09/01/2021 Building Setbacks Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: I Right: I Parkina Soaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee Designer: State Lie: State Lic:C-029595 0 m0coeo 0 Address: O ° PhoNO CONSTRUCTION WORK °° c°oo Special Conditions: o oc Fire Planning Department - ° Plan check Fee Fair Share SJH Trans ° e In -lieu Housing Fee Fire Department Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 dZonQW SATUR®AIS ° ° e ° e Fire Department e e e e $0.00 Fire Inspection: e $be00ee $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 $0.00 Fee Due at Permit Issuance : $121.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 11 1 herebyaffirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons Indicated below b the checkmark s I have laced next to the applicable item(s) P Y P O ry P O� Y O P PP O lection 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 le 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 rofessions 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 of more than five hundred dollars ($500). - - 1, as owner 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, usiness 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 nprovements 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 n roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not ply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) all a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and rofessions Code, is available upon request when this application is submitted or at the following Web site:http://w v .leginfo.ca.gov/calaw.htmi. ignature of Property Owner or Authorized Agent A Date ICENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury -that I am licensed under provisions of Chapter 9 (commencing with Secl'Qn ZQ9G of Division 3 of the Bu ess and Professions Code, and my licen is in full force nd effect. License Class License No D /G�—.,2/) Cont ct Signature ��Y1�?' *ifd'� s� - IORKERS' CQMPENSATION DECLARATION ARNING: FAILUR6ie SNI URE 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 PII RCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. nereby affirm utldAYpgnalty of perjury one of the following declarations: .... 1t Rave 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 th Nuance of the work for which this permit is issued. Policy No. .... sue and twill 1intain 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' compensatioi urance carrier and policy number are: amec • • Policy Number Expiration Dale 1e of Agent 16%performance of the 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 bgdle subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions..! /Dt 'r— weby affirm ander penalty of perjury 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. 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 state law Ing con I authorize representatives of thi ity� y or city to enter the above= 1 for inspection purposes. /� i��^ .,.hire nr Prnnurh, n%.,nor nr mrthnri nonh �.�.� �i'J -e Print Pronertv Owner's or horized De ame < ,-04o�y O DATE oillITARATION OF CMPLCE WITH CODE OF FEDER I BY o4rREGUL AIONS PART0610TITLE 40 AND AQMD RULE AL I FOR OFFICEVSE ONLY PERMITEXPIRED I l ✓ - l IV ISUBMITTED ASBESTOS NOTIFICATION TO PERMITFINAL (/�s//L / iL✓IA} �UASBESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATEOF ( _ % PROPOSED D—EWLITION. OCCUPANCYISSUED SIGNATUI1_��