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Home My WebLink AboutX2021-0861 - Permitsgw •f,� City of Newport Beach - Building Division *X2021-0861* COMB Permit: X2021-0861 ¢,�.. 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 0797-2021 `� Permit Counter Phone (949)644-3288 .. „. Inspection Requests Phone (949)644-3255 `'rcrrarar -'' Combination Type - CIP ELEC MECH PLUM Issued Date : 04/30/2021 Inspection Area : 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0413012024 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: 355 PLACENTIA AVE NB St: 1 FI: 2 Unit: 210 .... Description: COMM TI "SEAN NIKRAVAN" 518 SF ' Legal Desc.: P M 154-01 PAR 1 UNIT 5 OF PROJ LOC ON AP 425-111-06 TOGETHER . ° • • • ® • mmmeom Owner: NGUYEN KHOI Contractor: SAN LUIS BUILDERS INC Architect: ONG FRANCIS e omm• • ° • • Address: 355 PLACENTIA AVE STE 99 Address: 1422 E LEMON AVE Address: 4122 GLENWOOD ST • m NEWPORT BEACH, CA 92663 BRADBURY CA 91008 IRVINE CA 92604 e • e • • ° Phone: Phone: 626.945-5725 Phone: 714.892-5737 State Lic:C018585 • •' ••• •�89 •m• •• m Applicant: TRAN ANNIE Con State Lic: 556398 Engineer: •.•mm • Address: 14542 HARPER ST Lic Expire: 04/30/2023 Address: • • • o MIDWAY CITY, CA 92656 Bus Lic: BT30075153 • • • m o 0 Phone: 714-478-8665 Lic Exp Date: 04/30/2022 Phone: State Lic: o • ® • • o • o Code Edit: 2019 Worker's Compensation Insurance Designer: • ••o•oo ° Type of Construction: V-B-SPR Carrier: STATE COMP Address: mm oo m •m m ° Occupancy Group: B Policy No: 9238606 Added /New sq.ft. Bldg: 0 Expire: 11/04/2021 Phone: Added /New sq. ft. Garage: 0 No of Stories: 3 Building Setbacks Rear: / Special Conditions: No of Units : 0 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $94,000.00 Building Permit Fee: $1,161.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $1,010.07 Additional Fee : $0.00 Plan check Fee : $46.25 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $30.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $65.80 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $94.00 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $303.96 San Dist: $0.00 Building Green Fee : $4.00 Mechanical %: $238.82 NMUSD Fee: $0.00 $0.00 Plumbing %: $195.40 $0.00 TOTAL FEE : $3,149.29 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee $1,399.75 Fee Due at Permit Issuance : $1,749.54 PUBLIC WORKS APPROVAL: PLAN CHECK BY: 5G-� 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 ie 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 'rofessions 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 of 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, 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 nprovements 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 nproved for the.purpose of sale). I, as owneibavl`414 property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pglg jo an owijerof property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 19m exempt f;" licensure under the Contractors' State License Law for the following reason: 11 rrry.signature below I acknowledge 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 legallt ell.arstructurt that Lhave built as an owner -builder if it 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 'rofessions Cod@, is available upon request when this application is submitted or at the following Web site,.htlp://www. leginfo.ca.gov/calaw.html. ig04tUre of F P ty Owner Or Authorized Agent Date IC.gNSED QW11iACTOR'S DECLARATION K0_1 hereby affirm IhMIpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 0) of Division 3 of the Business and Psions Cod��d ray license is in full force Vdeffect. License Class License No Oat .,1 Contractor Signatu/ !� Gt)RKERS' �OIIpPENSATION DECLARATION �— IARNING: FAILUREYO SECURE WORKERS' 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 tArdFPCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. h0raay affirm tMer penalty 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 th, erformance of the work for which this permit is issued. Policy No. .[I have 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' compensatior s nce carrier and policy num er are: _ :arrier �-f(", �xH Policy Number ola3rd60S — Zp� Expiration Date /04/2074 lame of Agent Phone # I certify that, in the performance 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 Iat, if I should becomt'��s/bject to the workers' compensahpon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignatu re of Applicant I� .li/--c-,�C� Cat IECLARATION = I ONSTRUCTION LE hereby affirm under p ally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, CI it Code). Ender's Name - Lender's Address y 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 all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or couno enter t e abov identified property for inspection purposes. �� L ,r ianature of Prooertv Owner or Authorized Agent %� �^�� Print Property Owner's or Authorized Agent's Name G�ai�>s w(esty, c{ 0 ACTION DATE BY ' DEC-bkRATTONN OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT CANCELLED EPA PERMIT EXTENDED AD PERMITFINAL - 'J�'(, ( f ASBEST TIFICATION IS NOT APPLICABLE TO CERTIFICATEOF R OLITION !/ OCCUPANCYISSUED oEDD _ IG NA F. P