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Home My WebLink AboutX2021-3041 - PermitsCity of Newport Beach - Building Division COMB Permit: X2021-3041 .. 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0846-2021 Permit Counter Phone (949)644-3288 , ) v:. Inspection Requests Phone (949)644-3255 Combination Type - BLDG Issued Date : Inspection Arearea :2021 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 11/09/2024 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: 280 EVENING CANYON RD NB Description: DEMO EXTG POOL "METHOD B" Legal Desc.: N TR 1116 LOT 62 { Owner: MENDELLSTEVE Address: 233 JASMINE AVE CORONA DEL MAR, CA 92625 Phone: Applicant: TEALE MARK Address: 2900 BRISTOL ST BLDG A203 COSTA MESA CA 92626 Phone: 949-975-0123 Code Edit: 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: $4000.00 Building Permit Fee: $122.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $2.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $125.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Contractor: BLACK PETE CONSTRUCTION INC Address: 1788 MONROVIA AVENUE COSTA MESA CA 92627 Phone: 714-612-7678 Can State Lic: 692383 Lic Expire: 08/31/2022 Bus Lic: BT00003226 Lic Exp Date: 0413012022 Worker's Compensation Insurance Carrier: EXEMPT Policy No: Expire: Building Setbacks 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: I Left: I Right: / 'arkina Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Plan Check Fee Architect: Address: �� S Phone: State Lic: 47�Engineer: 0 Address: Phone: State Lic: - Designer: , Address: ----- Phone: Special Conditions: Fire 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 $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $125.00 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 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 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 Iicensure 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 not more than five hundred dollars ($500). 111, as owner of the property, or my employees with wages as their sole compensation, will do L) 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, 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 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). ❑ 1 am exempt from Iicensure under the Contractors' State License Law for the following reason: By 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 legal) sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Djvision 3 of the Business and Profess ns Co , and my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 `,:OST OF' COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm w,oer p.:nalty of perjury one of the following. declarations: 1 hzie and wi'.' 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 the Performance of the w,rk for which this permit is issued. Policy No. ❑1• hava and wit. ,T,antain 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' compensatio insurance carrier aid policy number are: bafrier Policy Number Expiration Date a e of Agent Phone # I` ertffy that,!n th.�'p-arformance 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 t, if I should become sub to the woorrk��'j ' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Sig,,atureof Appl,caui_ .�/ �' Date_ DECLARATION REGARDING CON9TRUCTION LENDING AGENCY I hereby 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). Lender's Name Lender's Address By 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 county t enter the above- entified property for inspection purposes. G O7 A`�,n Signature of Property Owner or Authorized Age �— Print Property Owner's or Authorized Agent's Name /J v'YK Date ACTION DATE e DECLARA ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED QM D PERMITFINAL �� / �\ Q ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF l V PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: