HomeMy WebLinkAboutX2021-0010 - PermitsuU."'.
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Combination Type - BLDG
COMB Permit: X2021-0010
Project No : 2357-2018
Issued Date : 01/04/2021
Inspection Area : 1
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY u71051ZUZ4 UK PENmr I WILL BE INVAuu
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: 4313 CHANNEL PL NB
Description: SFR BLOCK WALL 6' X 37 LF & 60 LF (CITY STD PLAN) INSIDE PIL ry y � r^1®�,/r�
Legal Desc.: CANAL SECTION LOT 7 BLK 143(AND NELY 4.42 FT LOT 6BLK 143 ON SATURUA lr 5
Owner: VAN DUONG
Address: 13880 HARBOR BLVD #6D
GARDEN GROVE, CA 92843
Phone
Applicant: DONG TRUONG
Address: 10692 SILVE G
GARDEN GR V
Phone: 714-204-287 _
Code Edit : 1
Type of Construction: B
Occupancy Group:
Added /New sq ft. Bldg: �.
Added /New sq. ft. Garage:
No of Stories: 0
No of Units : 0 ;
Bldg Height: 0
Bldg Sprinklers:
Flnod Zone: X
Building Permit Fee:
Plan Check Fee: $0.00
Overtime Plan Ck:
Investigation Fee:
Record Management:
Energy Compliance:
CA Seismic Safety:
Disabled Access
Hazardous Mat
Building Green Fee
PROCESSED BY:
CA 92843
9 Dade:
TOTALFEE:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor: OW NERIBLDR
Address: DONG TRUONG
Phone: 714-260-5987
Expire:
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sue-- Wodcer's Coensation Insur
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lkw
Building Setbacks Rear 5'
Front 10'
bb ', Left 3'
Right 3' _.
Architect:
Address:
Engineer:
If applid'
800/po 0 100/0 refund
Address:
to Whrn ..
Special Conditions: LIQUEFACTION
& HIGH DENSIT
Excise Tax: $0.00
Planning Department -
"Five apart
Additional Fee : $0.00
"' Plan check Fee.
$46.25
'. Eir Inspe
Grading Bonds F W.00
i Gt-atliAg�Pon It � $ .00�
�('ir,Trling•12er it F $0.00
Fair Share:
SJH Trans :
In -lieu Housing Fee:
$0.00
$0.00
$0.00
Fire Plan R
Demolition
Building I
Gradir PC*Fees d\ $0.00
Public Works Department-
General f
(11rV4�irniip.�Fee` iu / $0.00
Park Dedication :
$0.00
PAN Plan Check :
$0.00
ad'ng B
Electrical %: $0.00
San Dist:
$0.00
r.bea.• M ° 0.00
NMUSD Fee:
$0.00
Plumbing %: $0.00
Lic:
$0.00
$0.00
m ^ $0.00
$0.00
$0.00
" $0.00
$0.00
$0.00
Fee : $0.00 Fee Due at Permit Issuance : $295.25
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
P PPROVAL TO ISSUE:
�
Z
CA J
ay
n i
X
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 Bkwiness 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, or my employees with wages as their sole compensation, will do (_) all of or U portions of the 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 to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
ants 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
r�oved the purpose of sale).
jir'�� er of the property, am exclusively contracting,.w't-t}_licerued.. gntr c_I s.to..coast[Dct,the pS*QL-(Section 7Q44 Business and Professions Code: The, Contractors'-, License Law does not
T,/mexempt
ap Iywner of property who builds or improves thereo who on acts cts with a licensed Contractor pursuant to the Contractors' State License Law) ;.
from licensure under the Contractors' Stat Li ense w r�e oil wi T
y my signature below I acknowledge that; except'fojr`my p so r e. n hich must have resided as one year prior to completion of the improvements coverer! by this permit, I cannot legal)
sell a structure that I have built as an owner -builder if it has not been onstructe in its entirety by li ed contractors. I understand that a copy of the applicable law, Section I V 4 of the Busin sand
Professions Code, is available upon request w s application �-6f at the-folioFinfWeb site http://www.leginfo.c"ov/calaw.htmi.�,rn • _�, I -„d �^
Signature of Property Owner or Authorize Ageq
LICENSED CONTRACTOR'S DECLRA
I hereby affirm under penalty of perjury that I ami: ce a 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
and effect. License Class - 'cerise No - Date -_L2 LO - �fiorrtfactecSignaturs
WORKERS' COMPENSATION DECLARA ION
WARNING: FAILURE TO SECURE WORKERS' COM NSATIPN COVERAGF IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLORS Q100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDE FORM SECTION D706 OF THE LABOR CODE INTEREST, AND ATTORNEY'S FEES.- - F
I hereby affirm under penalty of perjury on of tf followin§ yleclarations
I have and will maintain a certificate Hof cc % f-insure for workers -compensation, LSsued by..lhe Ahector of Industrial Relations as provided for by Section 3 00 0#: the Labor Code, for th
performance of the work for which this pe it is issued. Po icy No.
I have and will maintain workers' com@ensation in urance, as required by Section 3700 of the Labor Code for the performance of the work for which this permit is isstd. My workers' compensatio
insurance carrier and policy number are _ _ .� e -
Darner OI y. P'S - ¢?`s s z iration•Date E
rz
ame of Agent ' ' ' a "' `' . S_ Phone #
I certify that, in the performance of the o for whhich this (W As�0 of employ any person in any manng5-¢p,a¢a�t4.p,e<Come subject to the workers' compensat on laws of California, and agre
th , if I should become syb'ect to theyw'o ers�nsation`l` "ro l lb s o 00 of the Labor Code, I shall forthvriBvltlHH ttbbrriiff 1�Y+��h4rhhh those provisions. 1�/I _ (�
Signature of Applicant�X/.. h/ //•
DECLARATION REG OING ¢ f0 AGENCY -
I hereby affirm under nalty of -perjury th t there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, it C
Lender's Name Lender's Address _ :.,, • _, a ..
By my signature below, I certify to each o the—ToirWin ""t
I am the property owner or authorized't�- ' 's �beRa . - _ -- _ - -_ - �- - -
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 bolding construction.
I authorize representatives of this city or county o ter the abo 'dentified party fo nspection purposes.
Signature of Pro art Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name
ACTION
DATE
BY E
DECLA 1 F MPU WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGU TIONS PART 61 OF TITLE 40AND AQI RULE
1403
PERMIT EXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO -
UEPA '
UACMD
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PERMITCANCELLED
PERMITEXTENDED
PERMITFINAL
CERTIFICATE OF
PROPOSED DEMOLITION
OCCUPANCY ISSUED
SIGNATURE: