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Home My WebLink AboutX2021-2827 - Permits+c City of Newport Beach - Building Division 3 G 100 Civic Center Drive, Newport Beach, CA 92660 :..1 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG ��u11 COMB Permit: X2021-2827 x 2 2 1 2 8 2 A Project No: 2460-2021 Issued Date : 10/19/2021 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 1011912024 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: 1822 BUTTONSHELL LN NB Description: POOL DEMO USING CITY STANDARD METHOD'B' Legal Desc.: N TR 3763 LOT 69 Owner: SHEA PETER Contractor: LANDCRAFTERS INC Architect: Address: 1822 BUTTONSHELL LN Address: 29512 ANA MARIA LANE Address: NEWPORT BEACH, CA 92660 LAGUNA NIGUEL CA 92677 Phone: Phone: 949-249-1086 Phone: State Lic: Applicant: ELLISON PAUL Can State Lic: 754071 Engineer: Address: 24642 VIA RAZA Lic Expire: 09/30/2022 Address: LAKE FOREST CA 92630 Bus Lic: BT30039467 Phone: 949-683-9861 Lic Exp Date: 0513112022 Phone: State Lic: Code Edit : 2019 Worker's Compensation Insurance Designer: Type of Construction: Carrier: EMPLOYEE SERVICE GROUP Address: Occupancy Group: U Policy No: WC5897031 Added /New sq.ft. Bldg: 0 Expire: 12/01/2021 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Building Setbacks Rear: / Front: / Special Conditions: 8 k Bldg Height: 0 Left: 1 n �" L_"a,e6 Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $10,000.00 Building Permit Fee: $246.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $214.02 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 $0.00 Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 PM/ Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $0.00 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE: $461.02 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $461.02 oo" Qom PROCESSED BY: PUBLIC WORKS APPROVAL: a om r m"- omm 0 ® m am ° m �o ZONING APPROVAL: PLAN CHECK BY: •� o m GRADING APPROVAL: APPROVAL TO ISSUE: mom o 0 0 000 0 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 itGm(s) action 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 far 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 fessions 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 more than five hundred dollars ($500). Ll I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of a improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7C apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra ❑ 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 o sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .11 Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7001 and effect. License Class License No Date I COMPENSATION DECLARATION ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. '(y affirm under penalty of perjury one of the following declarations: ryave and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Dire, finance of the work for which this permit is issued. Policy No. the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the )letion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). e year prior to completion of the improvements covered by this permit, I cannot understand that a copy of the applicable law, Section 7044 of the Business and 3 of the Business and Pro Contractor Signature TIES AND CIVIL FINES UP TO ONE Date is in full force DOLLARS ($10D,000(, IN ADDITION TO THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for 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' -carrier and policy number are: ie of Agent certify that, in the p( if I should become Policy Number permit is issued, I shall not employ any person in any t provisions of Section 3700 of the Labor Code, I shall sgnature of Applicant )ECLARATION REGARD ¢O U N LENDING AGENCY hereby affirm under penalty d,perjury that there is a construction lending agency for the performance of the work fol .ender's Name Lender's Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the pWove-" 'lf. I have read this application and the information I hav I agree to comply with all applicable city and countys re ng to building construction. I authorize representatives of this city or county to ed p spection purposes. signature of Property Owner or Authorized AgentPrint Property Owners ACTION DATE BY DEC RA ON OF COMPLIANCE WITH CODE OF FEDERAL FOR REGU TIONS PART 61 OFTITLE 40 AND AOMD RULE PERMITEXPIRED ••• '• -:_ • • 1 VI SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED : : • • • • DEPA • • •: PERMIT EXTENDED* • • • • QMD PERMIT FINAL ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF 1 ` c•• PROPOSED DEMOLITION OCCUPANCYISSUED • • ••• c• ••• •' SIMATURE: • s • • e• e s • • • e • • m e e • se® ee e• eee ee Date so as to become subject to the workers' compensation I ws of California, and agre i comply with those provisions. ` Date_ (� I i this permit is issued (Section 3097, C' Code). USE ONLY Name \-1 '° r' `�`+e� Date