HomeMy WebLinkAboutX2021-3294 - Permitsnth City of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111 COMB Permit: X2021-3294
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 1 3 2 9 4 Project No : 2853-2021
Permit Counter Phone (949)644-3288
;. Inspection Requests Phone (949)644-3255
c'�ifYelY'��S
Combination Type - GRAD Issued Date :
Inspection Arearea :2021
3
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, PROJECTS MUST BE COMPLETED BY 12/06/2024 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: 1607 CORNWALL LN NB
Description: SFR YARD DRAINAGE (CITY STD PLAN)
Legal Desc.: N TR 3607 LOT 20
Owner: TRAN HAI
Contractor:
OWNER/BLDR
Address: 1607 CORNWALL LN
Address:
TRAN HAI
NEWPORT BEACH, CA 92660
Phone:
Phone:
Applicant: TRAN HAI
Can State Lic:
O/B
Address: 1607 CORNWALL LN
- Lic Expire:
NEWPORT BEACH, CA 92660
Bus Lic:
Phone: 323-203-7800
Lic Exp Date:
Code Edit: 2019
Worker's Compensation
Insurance
Type of Construction: VB
Carrier:
Occupancy Group: U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: /
No of Units : 1
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Right: I
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
State Lic:
State Lic:
Designer:
TRAN HAI
Address:
1607 CORNWALL LN
NEWPORT BEACH CA 92660
Phone:
323-203-7800
Special Conditions
Hazard Zone : N
Construction Valuation:
$0.00
Building Permit Fee:
$0.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee: $0.00
Additional Fee:
$0.00
Plan check Fee
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans
Record Management:
$2.00
Grading Permit Fee:
$237.00
In -lieu Housing Fee
Energy Compliance:
$0.00
Grading PC Fee:
$199.00
Public Works Department -
CA Seismic Safety:
$0.00
WQ Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access :
$0.00
PAN Plan Check :
$50.76
Hazardous Mat
$0.00
Electrical %:
$0.00
San Dist:
$0.00
Building Green Fee :
$0.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
Plumbing %:
$0.00
TOTAL FEE: $540.75
PROCESSED BY:
ZONING APPROVAL:
Fire Department
$0.00
Fire Inspection:
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
Plan Check Fee : $0.00 Fee Due at Permit Issuance : $540.75
PUHL'C WORKS APPROVAL:
PLAN CHECK BY:
GRADING APPROVAL: APPPOIJAL TO ISSUE:
�F d
ro
� J
0
A
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
1e 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).
7 I, as owner of the property, or 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,
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
ZV onts 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
DID ed for the purpose of sale).
s 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
Tonly 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
ly my signature below I acknowledge that, except for my personal residence in which must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall,
ell a structure that I have built as an owner -builder if it has of San c nstrL
In its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request whe t s appli ati n is su Itte or at the following Web site:http://www.leginfo.ca.gcv/calaw.html. t I
signature of Property Owner or Authorized Agent D
.ICENSED CONTRACTOR'S DECLARATI N
hereby affirm under penalty 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
Ed effect. License Class License No Date Contractor Signature
COMPENSATION DECLARATION
ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES.
hereby affirm under 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
'ormance of the work for which this permit is issued. Policy No.
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' compensa
Trance camier and policy number are:
Policy Number
to of Agent
Date
certify that, in the performance cif the work for which t ermit 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
if I should becomeRI`NG"CONSTRUCTION
ec o t e wor ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.ynature of Applicant)tl C?iZ/'%2Z—(
CLARATION REC�LENDING AGENCY
areby 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).
Ider's Name 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 all applicable city and county Ordi ances and aws relating to building construction.
I authorize representatives of this city or cou ter he ab-identi led property for inspection purposes.
Signature of Property Owner or Authorized Agent vePrint Property Owners or Authorized Ag
ACTION I DATE I BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
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CERTIFICATE OF / PROPOSED DEMOLITION
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