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Home My WebLink AboutXR2023-1921 - Permits�agW WORT City of Newport Beach II III I II IIIII IIIIIIII IIII II III III I II COMB Permit: XR2023-1921 A Community Development Department - Building Division X R 2 0 2 3 1 9 2 1 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1694 ' = Permit Counter Phone: (949) 718-18BB Issued Date : 1011312023 ».newportbeachca.gov/civic Final Date: C4�IF(J0.N\P Combination Type - Permit Status: Issued Work Class - Other Inspection Area : 8 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address: 1121 KINGS RD Legal Desc : P BK 51 PG 7 PAR 1 Description : SFR RAISE RETAINING WALL HEIGHT BY 18" 50 LF *122-0349* Owner: AZADIAN GHASSEM GUS TR Address : 1121 KINGS RD NEWPORT BEACH, CA 92663 Phone: (714)290-3208 Applicant: JOHN DINH TRAN Address: 11251 GARDENAIRE LN GARDEN GROVE, CA 92841 Phone: (714)815-2356 Contractor Address : Phone: Con State Lic Lic Expire Bus Lic : Bus Lic Expire Workers' Compensation Insurance Carrier : Architect Address Phone: State Lic Engineer: JOHN DINH TRAN Address : 11251 GARDENAIRE LN GARDEN GROVE, CA 92841 Phone: (714)815-2356 Owner/Builder : AZADIAN GHASSEM GUS TR Policy No: Designer Address : 1121 KINGS RD W. C. Expire: Address: NEWPORT BEACH, CA 92663 Phone: (714)290-3208 Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $3,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U No of Units : 0 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 0 Added/New sq. ft. Garage : 0 TOTAL sq. ft. 0 Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone : R-1 - Single -Unit Residential �// PROCESSED BY: _ (f SPECIAL CC NDITONS: 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 items) (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 Business and Professions Code) or that he or she is exempt from lieensure, and the basis for the alleged exemption. Any violation of Section 7031b by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). 11 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 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 improved for the purpose of Sale). i❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to constructthe project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ',.apply 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). r❑ I am exempt from licensure under the Contractors' Stale License Law fort e following reason:_ By my signature below I acknowledge that, except for my personal residenc 1 which I must have resided forat least one year prior to completion of the Improvements covered by this permit, I cannot legal sell a structure that I have built as an owner -builder if R of been cc e in its entirety by IiconsGd contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code., is available upon request when this pp cation is owing Web site;httpiliwww.leginfo.ca.govlcalaw.html, Signature of Proparty Owner Or Authorized Agent — —Date r '..LICENSED CONTRACTOR'S DECLA..RATION - I - - I 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 and effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION YARNING FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS If100,0001, IN ADDnTON TO T 'ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COD£, INTEREST, AND ATTOA EY'S FEES. hereby affirm under penalty of perjury one of the following declarations, 1 have and wilf maintain a certificate of consent to self -insure for workers' compensation, Issued by the Director of Industrial Relationsas provided for by section 3700 of the Labor Code, for rerformance 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' rance carrier and policy number are: Policy Number Date is of Agent Phone # certify that, in the performance of the work for which this ;permit is issued., I shall not employ any person in any manner so Be to become subject to the workers' compensation laws of California, and . if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. M Dai ECLARATION REGARDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the workfor which this permit is issued (Section 3097, Civil Code). endar's Name _ Lenders Address y my signature below, I certify to each of the following: I ant the property owner or authorized to act on the property owner's behalf, I have read this application and the information I have pr�ov^'Ided is Derrect. I agree to comply with all applicable city and county Ord' es and st w relating to building construction. I authorize representatives of this City or county to en rt above- a ie�property for inspection purposes. %✓/' N ACTION DATE By i DECLARAT€ON OF COMPLIANCE WITH CODE OF FEDERAL I REGULATIONS PART 61 OF TITLE 40AND AQMD RULE 1403 FOR OFFICE USE ONLY PERIN4 EXPIRED �TIUBMITTED ASBESTOS NOTIFICATION TO ER PNlITCANMiED _- 1,,,�EPA FERNiTEXTENDEDt_0AQMD PERT4fIT FINAL" _ � �(� _ //�LI ASBESTOS NOTI FICA NON IS NOT APPLICABLE TO CERTIFICATE Of 7 ✓/O// t PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: