HomeMy WebLinkAboutXR2023-0568 - Permitsc EwPoRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
a' Community Development Department - Building Division X R 2 0 2 3 0 5 6 8
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
ceu P Inspection Requests Phone: (949) 644-3255
9�/FORN� newportbeachca.gov/inspections
Combination Type - SFP
Work Class - New
COMB Permit : XR2023-0568
Plan Check No : 2357-2018
Issued Date : 0310112023
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 BILK 143 (AND NELY 4.42 FT
LOT
Description: NEW SFR W/ ATTACHED GARAGE 1408 SF $ 393 SF (RENEW EXPIRED PERMIT)
Owner: VAN DUONG
Contractor :
Architect :
Address: 13880 HARBOR BLVD # 6 D
Address:
Address
GARDEN GROVE, CA 92843
Phone:
Phone :
Phone
Con State Lic :
State Lic : u o o u
Lic Expire:
......
°°°°
Applicant: VAN DUONG
Bus Lic:
Engineer:
Address : 13880 HARBOR BLVD # 6 D
Bus Lic Expire :
Address : ° ° .0
GARDEN GROVE, CA 92843
°
o° °
Phone:
Workers' Compensation Insurance
Phone: °° °°
° a 0
Carrier :
° oaoo°
° o
Goo
Owner/Builder : VAN DUONG
Policy No:
Designer:
° ° 0
Address: 13880HARBORBLVD#6D
W.C.Expire:
Address: o°
u°°°°°
GARDEN GROVE, CA 92843
.
°O°°`
Phone:
Phone: ° °
o°0000
° ° ,
0 0
u o°
0 0
Code Edition : 2016
Fire Sprinklers : YES
Construction Valuation
Type of Construction : V-B
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg: 0
Occupancy Groups : U,R-3
No of Units : 1
Alteration sq. ft. Bldg :
Bldg Height :
No of Stories : 3
Added/New sq. ft. Garage: 0
TOTAL sq. ft.: 0
Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone: R-2 - Two -Unit Residential
PROCESSED BY: GdC� NO CONSTRUCTION NOISE
SPECIAL CONDITIONS: 1 r., r.-,-�—"
ON THE WEEKEND
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate. License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicableiteri
(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 licansure-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 L) all of or U portionsofthe 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 toan owner of property who, through employees' Or personal effort, builds or improves the property, provided that the
improvements are notintended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the Owner -Budder will have the burden of proving that it was not built or
improved for thepurpose of sale),
Dias 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 loan owner of property who builds or Improvesthereon, 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:
8 m y Signature below I acknowledge that, except form y } g g p y personal residence in which I must h 6 resided for at least one year priartp mpled on of the improvements: covered by this permit, I.cannat legal)
sell a structure that I have built as an owner -builder if ithas not been Constructed in its ontlr lieensad'comractors: I understand that a Coy of the: applicable taw, Section 7044 of the B iness-ph
Professions Code, is available upon request when t. applicali- a bm d orat t fate 'WWobsite.http.,I/www.leginfo.ca.gov/�le site.http:Nwww.leginfo.ca.gov/cola tmL DDra /
Signature of Property Owner or Authorized Agent. / Date v O
LICENSED CONTRACTOR'S DECLARATI.
1 hereby affirm under penalty of perjury that I am licensed under. provisions of Cho or 9 c manning with Section 77000) of D' Rlate. -Qf the Business-and.Pro
fe s aniJ my IC s is In -full farce
and effect. License Class License No Dat mS 8- �j Contractor Si atur -
WORKERS'COMPENSATION DECLARATION / r / _
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLGYERT40 CRIMINAL PENALTIES AND CIVIL FINES UP TO.ONE HUNDRED THOUSAND VOL
LARS ($f0 00); rN ADDITION TO THE
COST OF COMPENSATION rAMAGES Ae PROVIDED FOR IN SECTION 3709 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm unda� renalty of perjury one of the following declarations:
ha+L and wail maintain a carlificate 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, forth
performance of tha wcrl: for which this permit is issued. Polley ND,
L`-11l love and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of theworkfor which this: permit is issued. My workers` componsatior
�nsumnce carrier alp pulicy number are:
Currier_ Policy Number Expiration Date
Name of Agent _ _ _ _ _ _ Phone#
t c:-ti`y that, in the performance of the work for which this permit is Issued, 1 shall not employ any person in any mannerso.as to become subject to the workers' compensationlaws of California, and agree
Ihat if I shuuld become subject to the workers' compensatlon provisions of Section 3700 of the Labor Code; I shall forthwith comply with those provisions.
Signature of Apphcant Date_
rrFy affirm urder penalty of perjury that there is a construction tending agency for the performance ofthework 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 theproperty 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 I rr^^'^ nl 'Iding cons tion.
I authorize representatives of this city or county t p T e-T above-idenjif ai r perty forinspectlon pure es.
ACTION
PERMIT EXPfRED
DATE BY I i DECLARATION OF COM PU CE WITH CODE OF Ft DERAL FOR OFFICE USE ONLY
REGOLATIbLVS PART6 TFTLE40 AND AQMD RULE
1403
PERMIT EXTENDED I I I L1AQM6
PERMIT FINAL /it Z1, \Q ASBESTOS NOTIFICATION iS NOT APPLICABLE TO
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