HomeMy WebLinkAboutXR2023-0570 - Permits (2)EWPoRT
City of Newport Beach
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
C4C/FOPN�P
newportbeachca.gov/inspections
Combination Type - SFP
Work Class - Other
�1111 11111111111111111111111111111111111111111111111111111111COMB Permit : XR2023-0570
Plan Check No: �357-2018
Issued Date: D3�or =5
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 : SFR BLOCK WALL U X 37 LF & 60 LF INSIDE P/L, 11/14/22 talked with GC 3yr deadline approval, working on wall to date. (RENEW EXPIRED PERMIT)
Owner: VAN DUONG
Address : 13880 HARBOR BLVD # 6 D
GARDEN GROVE, CA 92843
Phone: (;ilw)?,W- 9987
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 :
Contractor : Architect
Address : Address
Phone:
Phone:
Con State Lic :
State Lic
Lic Expire:
Bus Lic:
Engineer
Bus Lic Expire :
Address
Workers' Compensation Insurance
Phone:
Carrier :
Policy No :
Designer
W. C. Expire:
Address
Phone:
Code Edition :
2019
Fire Sprinklers :
NO Construction Valuation
Type of Construction :
V-B
Fire Hazard Zone :
NO Added/New/TI sq. ft. Bldg : 0
Occupancy Groups :
U
No of Units :
0 Alteration sq. ft. Bldg:
Bldg Height:
No of Stories :
0 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
a ° n `•— a i
PROCESSED BY:
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SPECIAL CONDITIONS:
ON THE WEEKEND
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat I am exempt from the Contractors' Slate License Law fOT the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(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 or 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 (_) ail of or U portions of the work, and the structure Is notintended 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
Improve tints 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
impr d 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 who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law),
0 I am exempt from licensors under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at leagt one year prior to completion of the improvements covered by this permit, I cannot legal
sell a structure that I have built as an owner -builder if it has not boe cted in its entir by Ilconsed cantraetor . I understand that a copy of the applicable taw, Section 7 I of the B frees rid
Professions Code, is available upon request when. t applica' isyw!bml d or at the-foVo g Wa6 site:httpJlw .Ieginfo.ca.govlcalaw.html. 2
Signature of Property Owner Or Authorized Agent l '�£i� - D
LICENSED CONTRACTOR'S DECLARATI N
I hereby affirm under penalty of perjury that am licensed under provisions of Chapter' ( mencing with Section of 'nisi of the Business and Pro Code, and m rise i n fuffirce
and effect. License Class License No Dat % Contractor Signatu 6�
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND O LLARS Is1 ,0001.IN ADDITION TO TH
COST OF COMPENSATION: DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm ur,der eenalty, of perjury one of the following declarations:
0 1 hs to and Oil ma'main a certificate Of consent to salt -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for tl
performance of the work for which this permit is issued. Policy No.
Lave and will mairttain 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'
rance carrier ai,i policy number are:
Policy Number
Date
is of Agent iron 9
certify that, in the performance of the work for which this permit is issued, I shall riot employ any person in any manner so as t0 become subject to the workers' compensation laws of California, and
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iignalum of AppEcani. Date.
L71",I,ARATION RkGARDING CONSTRUCTION LENDING AGENCY
hereby affirm under 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).
tinder's Name Lenders Address
ly 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, r
I have read this application and the Information I.have provided is correct. A—
I agree to comply with all applicable city and county ordinances and state laws relat0 construction.
I authorize representatives of this city or coun;yyjy.�nte�tLe above -idea property for inspectlo purposes. _ �� a n R �✓
ACTION
DATE.
BY DECLARATION OF COMP CE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 6 F TITLE AD AND AOMD RULE
1403
PERMIT EXPIRED
SUBMITTED ASBESTOS TIFICATION TO
PERMIF&IVELLED
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PERMIT EXTENDED
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ASBESTOSNOTIRCATIONISNDI"APPLICABLE TO
CERTIFICATE OF
PROPOSED DEMOLITION
OCCUPANCYISSUEO
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