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X2022-1527 - Permits
City of Newport Beach -Building Division 'Z71744 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 rp. Combination Type - BLDG IIII�Illll111�1[I�11lIIIIIIIII111111IIIIll1111�17IlIIIII P OMB OPerm6 oX2022-1527 J Issued Date: 0512712022 Inspection Area : 6 PERMIT EXPIRES 980 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 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: 2336 PORT LERWICK PL NB Description: SFR BLOCK WALL INSIDE P/L 6' HIGH BY 90 LF Legal Desc N TR 7845 LOT 42 Owner: NGUYEN JACQUELYNE Address: 2336 PORT LERWICK PL NEWPORT BEACH, CA 92660 Phone: 949-394-6606 Applicant: NGUYEN CHUC Address: 10282 TRASK AVE #B GARDEB GROVE CA 92843 Phone: 7141713-6780 Code Edit : 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft" Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Construction Valuation: $9,000.00 Building Permit Fee: $229.00 Plan Check Fee: $199.23 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $2.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee: $1.00 TOTAL FEE: $483.23 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: OWNER/BLDR Architect: ° ° ° ° ° Address: AUTH AGENT: CHUC NGUYEN Address: o °°° v°OOOo ��` Phone: 949-394-6608 Phone: State Lic" 0 0 Con State Lic: O/B Engineer: Lic Expire: Address: © ° ° Bus Lic: Lic Exp Date: Phone: State Lic: ° o 0 Worker's Compensation Insurance Designer: ° Carrier: Address: Policy No: Expire: Phone: 00 ® o000 Building Setbacks Rear: 10 Special Conditions: O/B FORM ATTACHED ° Front: 21 Left: 5 Right: 5 Use Zone: Parking Spaces: 0 Fire Hazard Zone: N Excise Tax: $0.00 Planning Department - Fire Department Additional Fee: $0.00 Plan check Fee: $52.00 Fire Inspection: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Electrical %: $0.00 San Dist: $0.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 Plan Check Fee: $0.00 Fee Drue at Permit Issuance : $483.23 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: OWNER -BUILDER ,DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for 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 4 usiness and Professions 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 not more than five hundred dollars ($500). I, as owner of the property, for my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and ProfessionsCode: 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 improvements 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 im roved for the purpose of sale). 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 ply n 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 exemp, t- , licensure under the Contractors' State License Law for the following reason: By my signature, —.Wow' I'Iacknowledge 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 legally S flZ tructure,that ohave, built as an owner -builder if i 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 Professions CodT; is a—vailable upon request whe applicatlop'�#tb fitted or e f `wing site:te:bftp://www.leginfo.ca.gov/calaw.htm1. of Property Owner or Authorized Agent ( 1� �4 II Da Z �— LICENSED CO`NTRACTOR'S DECLARATI V hereby affirrv. under �oenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code and my license is in full force any' efrect. LICa�ase Claiss License No Date Contractor Signature h'ArzMk: FAILURE l` SK P,ST OF COMPENSATION,.] 9nerEay affirm�undpr p have an6 Will rna ?erfprmance of thew I have and `will rrai nsurance carrier and p ame of Agent I certify that, in the performance of th 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 ogre lat, if I should become su ect e or ers' co sdtio rovisions�off Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Dat �� % / '! iECLARATION REG ING 'RUCTION LENDING AGIN�Y hereby affirm under penalty of 1peoury that there is a constructio ending agency for the performance of the work for which this permit is issued (Section 3097, Ci it Code). en A— Name P l h ! Lender's Address 3y 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 ail applicable city and countfordinances and state laws relating to building construction. I authorize representatives, of this city or county e ove-i f d roperty for inspection purposes. �, ! signature of Property Owner or Authorized Agent j 0 1� ° Print Property Owner s or Authorized Agent's Nam ��Ci / t� / Date ACTION DATE BY DE TION OF COMPLIANCE�JVITIEf CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLY 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED EPA PERMIT EXTENDED AQM D PERMITFINAL SBESTOS� NO/t IFICATIONQpISNOTAPPLICABLE TO OCCUPANCY I SUED CERTIFICATE OF J�e�� ��� p~� SIGNATURE �NJOLITj �✓+N� _ rION DECLARATION :)RKERS' 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 S AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. of perjury one of the following declarations: 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 rhich this permit is issued. Policy No. 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' are: Policy Number Expiration Date one #