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Home My WebLink AboutX2020-2169 - Permitswnn City of Newport Beach - Building Division IIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2020-2169 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 2 1 6 9 Project No : 1748-2020 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG PLUM Issued Date: 10/07/2020 Inspection Area : 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1010812023 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: 1105W BALBOA BLVD NB Description: DEMO SINGLE FAMILY RESIDENCE (5 BEDROOMS) 1756 SF Legal Desc.: NTR234BLK11LOT23 fR'SPECT-®R Owner: HAI TRINH Contractor: T M WRECKING & EXCAVATING Architect: Address: 12305 PROVINCETOWN ST Address: 15730 WINTERS LANE Address: SEAL BEACH, CA 90740 Phone: Plan Check Fee: $227.50 Applicant: MEDRANO TOMMY Address: 15730 WINTRS LN Lie Exp Date: RIVERSIDE, CA 92504 Phone: 951-776-2056 Code Edit : 2019 Type of Construction: VB Occupancy Group: R3 Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Building Permit Fee: $120.00 TOTAL FEE: $1,920.80 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: RIVERSIDE CA 92504 Phone: 951-776-2056 Phone: Con State Lie: Plan Check Fee: $227.50 Lie Expire: Overtime Plan Ck: $0.00 Bus Lie: Investigation Fee: $0.00 Lie Exp Date: Record Management : $0.00 Worker's Compensation Insurance Energy Compliance: $0.00 STAE FUND CA Seismic Safety: $0.00 0703500 Disabled Access: $0.00 0910112021 Hazardous Mat $0.00 $0.00 Building Green Fee: $1.00 TOTAL FEE: $1,920.80 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: RIVERSIDE CA 92504 Phone: 951-776-2056 Phone: Con State Lie: 392016 Lie Expire: 07/3112022 Bus Lie: BT30072143.. „ Lie Exp Date: 1013112021 Worker's Compensation Insurance Carrier: STAE FUND Policy No: 0703500 Expire: 0910112021 'Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant: Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: I Front: I Left: I Right: I f!ST Spa $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.80 State Lie: Engineer: PHAM LAN NGOC Address: 14645 SERON AVE IRVINE CA 92714 PhonENO ,0�°8ey66� g ppState Lic:C-029596 Desig Lln�'e@r: "6 R4.da< TION WOW Address: " ° OW ° o � °000 Phone: t{t��ttrA /� ,1 0 �VA &AI DGD° Special Condition . L I M DEMO SHALL B � �7 DAYS AFTER NOTIFICATION o eo c o° Planning Department - Plan check Fee . Fair Share : 0 oe SJH Trans: Fire Department In -lieu Housing Fee $92.50 Public Works Department - Park Dedication: $0.00 PNU Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $1,920.80 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: o -o . 0 oe Fire Department oo.. $92.50 Fire Inspection: $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $26.00 General Service $316.00 Refund Deposit $1,127.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance: $1,920.80 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'applicabig 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 n roved 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 only 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 I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall) ell a structure that I have 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 Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. lignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se tq iog 7000) of Division 3 of the Busin d Professi and m licens is in full force nd effect. License Class License No e /G�` 2C! Contracto nature ,�.�.*�= VORKERS' CQMPgNSATION DECLARATION w DARNING: FAILURE t8 SROURE 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 P61LgF•COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. affirm und&Wnalty of perjury one of the following declarations: .... le and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Ince of the work for which this permit is issued. Policy No. 1 and �+d4 Q�Ihtain workers' compensation insurance, as required by Section 3700 of the Labor Code, e carper an.dpolicy number are: • Policy Number Agent Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for for the performance of the work for which this permit is issued. My workers' Date :grtify th%t!in tha,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 wor ers' compensation laws of California, and agre, p I sho he a sub'e to the workerrs'zccoomspensati%�pr�o isions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ature of ITc'apt /L�-� /�4.x 1/,� /L'.d^ Date /d -'� - ✓J :reby 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 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 oil nd county ordinances and state Is �„tgle4lif iulidding conslruc I authorize representatives of this�jtyrlrcounty tester the above-' if property for inspection purposes. lignature of Property Owner or Au ACTION DATE PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED PROPOSED Print Property Owner's or Au odzed A OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE JE ONLY PART 61 OF TITLE 40 AND AQMD RULE ASBESTOS NOTIFICATION TO NOTIFICATION IS NOT APPLICABLE TO