HomeMy WebLinkAboutH2023-0148 - Permits�a�WPo� City of Newport Beach
Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
- ? Permit Counter Phone: (949) 644-3288
H Inspection Requests Phone: (949) 644-3255
C4��FOFN�P newportbeachca.gov/inspections
Mechanical Permit : H2O23-0148
Plan Check No : 2357-2018
Work Class : Other
Issued Date : 03/0112023
Inspection Area : 1
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 4313 CHANNEL PL Legal Desc : A TR CANAL SECTION BLK 143 LOT 7 CANAL SECTION LOT 7 BLK 143 (AND NELY 4.42 FT LOT
Description: MECH - NEW A/C CONDENSORS & FAIL. TAMPER -RESISTANT CAP REQ'D (RENEW EXPIRED PERMIT)
Owner: VAN DUONG
Address : 13880 HARBOR BLVD # 6 D GARDEN GROVE, CA 92843
Phone: (10)V-0-3 qP
Applicant: VAN DUONG
Address: 13880 HARBOR BLVD # 6 D GARDEN GROVE, CA 92843
Phone:
Owner/Builder: VAN DUONG
Address : 13880 HARBOR BLVD # 6 D GARDEN GROVE, CA 92843
Phone:
Code Edition : 2019 Fire Hazard Zone
Type of Construction
Occupancy Groups:
Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-2 - Two -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
Contractor
Address
Phone:
Con State Lie
Lie Expire
Bus Lie
Bus Lie Expire: ,
Workers' Compensation Insurance -
Carrier
Policy No: °
W. C. Expire:
NO Manufacturer:
Model# :
NO CONSTRUCTION NOISE
ON THE WEEKEND
s. P-•. - -
OWNER -BUILDER DECLARATION
I hereby affirm under penaltyof perjorythat I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(r)
$action 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
ho permit to file a signed statement that he or she is licensed pursuant to the provisionsof the Contractors! State License Law (Chapter!) (commencing with Section 7000) of Division 3 of the Business and
'rofesslons Code) or that he or she is exempt from ficensure 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
lo€ more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (.r.) portions of the work., and the structure is not intended or offered for sale (Section 7044,
lusiness 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
repro ments 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
Tt oved 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' State License Law does not
apply to an owner of property%,he 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.®� _
ty my signature below I acknowledge that, except for my personal residence in which I must have reslded fort -Oast 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 be constructed in t Is y y tcensed contraclGrs. I understand that a copy of the applicable law, Section 7044 of the BU Ina55 d
'rofessions Code, is available upon request When thi a atioq�Is s Itted o ctt th _ II Wing Weh sits:hitp:/lwvlw.laginto.ca:govlca[aw.html.
signature of Property Owner or Aulhorizetl Agent < - — - - Date
JCENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty at perjury that I am licensed under provisions of Chapt 9 (commencing with Section 0 } of D'. isi 3 of the Business and P o '' s Code, an myds lit full force
and effect. License Class Licenseo Dale Z Contractor Signatudf
NORKERS' COMPENSATION DECLARATION IF
rARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED OUSANO OOLLA (5100,0001, IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, ANO ATTORNEY'S FEES.
hereby affirm unLar p< nasty of perjury one of the following declarations:
.� I 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 Labor Code, for lh
�er.orwnice of the worn for which this permit is issued. Policy No.
:1I havo and will maintain 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' compensatiioi
turanre carder and policy number are:
:an er Policy Number Expiration Date
Inme or Agent Phone H
:11 ca,Gfy that, if, fee pal formance 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 agre
should become subject to the workers' compensation provisions: of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iglu ture of Applicant _ USES_
cCLARATiON NPr AROING CONSTRUCTION LENDING AGENCY
I s,vty affirm under penalty of perjury thatchers is a construction lending agency for the performance of the work for which (his: permit is issued (Section 3097. Civil Code).
erd- ,'r Name Lenders Address �
y my signature below, I certify to each of the following:
I am the property owner or authorized to Rot on the property owners 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 laws relating to building cons tion. ,/
I authorize representatives of this city or county tt ant �the above-k entifie any for inspection purpos s, /"
ionature of PmDertV Owner or Authorized, Y'C 1 �-%�P Print Property wner's or Authorized Agent's Nam'
ACTION
PERMIT EXPIRES?
DATE I BY
40 AND AOMD RU LE
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OCCUPANCY ISSUED
FOR OFFICE USE ONLY
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