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Home My WebLink Aboutx2021-2171 - PermitsCity of Newport Beach - Building Division t 0 100 Civic Center Drive, Newport Beach, CA 92660 tY 1y Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG PLUM IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2021-2171 x 2 0 2 1 2 1 7 1ry Project No: 0126-2021 Issued Date: 08/1712021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0811712024 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: 1115 ESSEX LN NB Description: DEMO (E) SFR, LEAVING PARTIAL FOUNDATION Legal Desc.: N TR 3000 LOT 43 00) Owner: PANAGALCOS GLENN Address: 404 E 16TH STREET COSTA MESA, CA 92627 Phone: 949-691-8020 Applicant: PANAGALCOS GLENN Address: 404 E 16TH STREET COSTA MESA, CA 92627 Phone: 949-691-8020 Code Edit : 2019 Type of Construction: VB Occupancy Group: R3IU Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 1 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: N Construction Valuation: $5,000.00 Building Permit Fee: $122.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 - Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $1,552.98 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: GPE BUILDER'S Architect: Address: 404 E 16TH STREET Address: COSTA MESA, CA 92627 Phone: 949-691-8020 Phone: Con State Lic: 1061932 Engineer: Lic Expire: 0113112022 Address: Bus Lic: BT30072992 Lic Exp Date: 09/30/2021 Phone: Worker's Compensation Insurance Designer: Carrier: NO EMPLOYEES Address: Policy No: Expire: Phone: Building Setbacks Use Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee : Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / 3ardno Soaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.98 Plan Check Fee 7J M State Lic: 0 GHAZLANIANDY 4202 ATLANTIC AVE #204 LONG BEACH CA 90807 562-253-2385 State Lic:C-060867 Special Conditions: HAULER: ROBERT'S WASTE NO CITY TREES ON SITE Planning Department - Plan check Fee: Fair Share SJH Trans In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $27.00 General Service $265.00 Refund Deposit $1,127.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $1,552.98 ° PUECIS: VJOR`kS APPRUV41_3 18 PLAN CHECK BY: APFI4O`JAL T9°I3SUL 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 apoliRa0le,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'1e 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 lenalty of of more than five hundred dollars ($500). 1, 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). 1 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 pply 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). 7 1 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 legall, 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.html. signature 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 Sectio 70 r or Division 3.of the Business and Pr es n Code, and my license is in full force nd effect. License Class License No Date — ZA Contractor Signature2 VORKERS' COMPENSATION DECLARATION 'ARNING: 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 ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 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. 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: IS of Agent certify that, in the if I should becon Iature of Applican Policy Number Date 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 he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DSX :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 city and county ,ordinances and state laws relating to building construction. I authorize representatives of this city or co ty me above -identified property for inspection purposes. c`^. n nature of Prooertv Owner or Authorized ADen ��..��— Print Prooertv Owner's or Authorized Aoent's Na 9 C�Wf� �AS ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED DATE I BY OF COMPLIANCE WITH CODE OF FEDERAL PART 61 OF TITLE 40 AND AQM D RULE D ASBESi05 r4OTIFICMrl&N 70 NOTIF ATI IS NOTAPPLICABLE TO O O I -TV - FOR OFFICE USE ONLY