HomeMy WebLinkAboutX2021-2424 - PermitsCity of Newport Beach - Building Division COMB Permit: X2021-2424
100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0846-2021
Y Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Issued Date : 09/10/2021
„ Combination Type - BLDG PLUM
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 09/10/2024 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 SFR W/ATT GAR 1742 SF 3 BEDROOMS
Legal Desc.: N TR 1116 LOT 62
Owner: MENDELL STEVE
Contractor:
BLACK PETE CONSTRUCTION INC
Architect:
TEALE MARK
e
Address: 233 JASMINE AVE
Address:
1788 MONROVIA AVENUE
Address:
2900 BRISTOL ST BLDG A203
e ,
CORONA DEL MAR, CA 92625
COSTA MESA CA 92627
COSTA MESA CA 92626
Phone:
Phone:
714-612-7678
Phone:
949-975-0123 State Lic:CO22162
Applicant: TEALE MARK
Con State Lic:
692383
Engineer:
HAKIM FADY
Address: 2900 BRISTOL ST BLDG A203
Lic Expire:
08/31/2022
Address:
124 PEONY
COSTA MESA CA 92626
Bus Lic:
BT00003226
IRVINE CA 92618
Phone: 949-975-0123
Lic Exp Date:
04/3012022
Phone:
310-422-1536 State Lic:C-075736
Code Edit: 2019
Worker's Compensation Insurance
Designer:
Type of Construction:
Carrier:
EXEMPT
Address:
Occupancy Group: R3/U
Policy No:
Added /New sq.ft. Bldg: 0
Expire:
Phone:
-
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: /
Special Conditions: TIGHT QUARTERS TO
No of Units : 1
Front: /
HAUL DEBRIS
- • -
Bldg Height: 0
Left: I
CERT RECEIPTS ATTACHED
Bldg Sprinklers:
Right: /
Flood Zone:
Use Zone: Parking Spaces: 0
Fire Hazard Zone : N
Construction Valuation: $15,000.00
Building Permit Fee: $122.00
Excise Tax:
$0.00 Planning Department
-
Fire Department
Plan Check Fee: $0.00
Additional Fee :
$0.00 Plan check Fee:
$0.00 Fire Inspection:
$0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee:
$0.00 Fair Share :
$0.00 Fire Plan Rev
$0.00
Investigation Fee: $0.00
Grading PC Consultant :
$0.00 SJH Trans :
$0.00 Demolition Fee
Record Management: $0.00
Grading Permit Fee:
$0.00 In -lieu Housing Fee:
$0.00 Building Dept Adm
$27.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00 Public Works Department-
General Service
$265.00
CA Seismic Safety : $0.00
WQ Insp. Fee :
$0.00 Park Dedication :
$0.00
Refund Deposit
$1,692.00
Disabled Access : $0.00
P/W Plan Check:
$0.00
Grading Bond:
$0.00
Hazardous Mat $0.00
Electrical %:
$0.00 San Dist:
$0.00
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00 NMUSD Fee:
$0.00
Plumbing %:
$10.98
$0.00
TOTAL FEE: $2,117.98
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
$0.00 Fee Due at Permit Issuance : $2,117.98
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: \I 1 Y l l
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forth a reasons) 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 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
not 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,
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 licensure 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 legall)
sell a structure lhac 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 Cod,, i:, available upon request when this application is submitted or at the following Web site:http://wvvw.leginfo.ca.gov/calaw.html.
3:gaats-e of ProFc rty Owner or Authorized Agent Date
LICENSED CCNI:PACTOR'S DECLARATION
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 Profe ions Code and my license is in full force
and'elrect. License Class License No Date Contractor Signature /Y
IIVORKERS' (_UMP�NSATION DECLARATION
NARNING: 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 I$100,0001, IN ADDITION TO THE
:OCT C F COMPENSATION,'IAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
h€raty 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 tht
performance of the .vol:< for which this permit is issued. Policy No.
hays 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 Expiration Date
of Agent
Iedify that, in the 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 workers' compensation laws of California, and agre
If I should becoplicarlJ mosubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / /
nature of Ap� Data
CLARATION REGARDING CONSTRUCTION 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
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 to enter the Vove-identified property for inspection purposes. /
of Prooertv Owner or Authorized
ACTION
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
I DATE I BY
tiff
0
pWZOMPLIANCE WITH CODE OF 5MI
PART 61 OF TITLE 40 AND AQMD RULE
ASBESTOS NOTIFICATION TO
LJASBESTOS NOTIFICATION IS NOTAPPLICA13LE TO
PROPOSED DEMOLITION M
FOR OFFICE USE ONLY
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