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Home My WebLink AboutXR2023-3032 - Permitsr cWpo/ �� City of New oft Beach y p ��111111111111111111111111111111111111111111111 II coMe Permit : XR2023-3032 a,• Community Development Department -Building Division X R 2 0 2 3 3 0 3 2 r ' r' - : 100 Civic Center Drive, Newport Beach, CA 92660 Plan Cheek No : 0846-2021 Permit Counter Phone: (949) 718-1888 Issued Date : 10/26/2023 newportbeachca.gov/civic Final Date: `''� •ro ay" Combination Type - yp "R 1 aye w-'? ""' o 93"p';!"a 77 °�"✓ Permit Status: Issued - - Work Class - Other Y a>+Y�y � al tl ��1 Inspection Area : 5 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 : 280 EVENING CANYON RD Legal Desc : N TR 1116 BLK LOT 62 Description: SFR (N) CMU WALL 36" HIGH BY 10' LONG AT P/L (X2021-0915) Owner: MENDELL STEVEN EUGENE TR Address: 233 JASMINE AVE CORONA DEL MAR, CA 92625 Phone Applicant: PETE BLACK CONSTRUCTION INC Address: 32565 B Golden Lantern,176 Dana Point, CA 92629 Phone : (714) 612-7678 Owner/Builder Address : Contractor: PETE BLACK CONSTRUCTION INC Address: 32565 B GOLDEN LANTERN, 176 DANA POINT, CA 92629 Phone: (714)612-7678 Con State Lie : 692383 Lie Expire: 08/31/2024 Bus Lie: BT00003226 ' Bus Lie Expire : 04/30/2024 Workers' Compensation Insurance Carrier: NO EMPLOYEES Policy No : EXEMPT W. C. Expire: Architect: MARK TEALE Address: 2900 BRISTOL ST BLDG A203 COSTA _ MESA, CA 92626 Phone: (949)975-0123 State Lie: Engineer: HAKIM FADY Address : 410 GODDARD, 200 I RVINE, CA 92618 Phone: (310)422-1536 Designer: Address Phone: Phone Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $5,000.00 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: 25, Side: 6, Side: 6, Rear: 6 , Flood Zone Use Zone PROCESSED BY: SPECIAL CONDITIONS: P/L AGREEMENT SCANNED REF REV2022-2021 [ hereby affirm under penalty of perjury that € 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 Ihat requires a permit to construct alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the pormit to file a signedstatement 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 permitsubjects 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 sale compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Bustness 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 thepurpose of sale). ❑ 1, 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 ra�ply to an owner of properly who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Stale License law), LJ I am exempt from loensure under the Contractors' State License Law for [he 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:tlwrrw.leginfo.ca.govlcalaw.html. 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 7003 of the Business and Prefessi dcanG'fifyllcense [s in full Lorca and effect. License Class License No Date L/ Contractor Sig naiu WORKERS' COMPENSATION DECLARATION. WARNING: FAILURE TO SECURE WORRIERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,W01,. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37706 OF THE LABOR CODE, INTEREST, ANC ATTORNEWS FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 performance of the work for which this pormit 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 whichthis permit is issued. My workers' ance carder and policy number are'. Agent Policy Number Expiration Date Phone rF /Certify that, in the performance of the war=-iING-A6EN[CT permit Is issued, I shall not empioy any person in any manner so as to become subject to the workers' compensation laws of California, and agre tat., if I should become subject to the work n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. _-_�4 / Ignature of Applicant Date ECLARATION REGARDING CO 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). enders Name _ _ Lender's Address y my slgnaYu-e hek+w: certify to each of Ilia fofollowing: I I the properly Owner or authorized to act on the property owner's behalf. I have read this drIplicalion and the information I have provided is correct. I agree to cd ip,/ with all applicable city and county ordinances and stale laws relating to building construction. ///""" ��JJJ /% I authorize ifTresentatrves of this city or county to�nler the ve-ide .'tied ropedy for inspection purposes. , /// /�/� � ianature of Prjnert; Owner or Authorized Anent Vn.A ra, : i'1 Print Prooerty Owner's or Authorized Anent s Name F/�h X , Date ArTION PERMIT EXPIRED PERA'IT CANC�," i ED PERMIT EXTEWIF9 PErif, Pll HNN_ � 1 CERT IPICATE A" OCCOPANCy l55WED DATE I BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE'40 AND AOMD RULE 1403 LI[SUBMITTED ASBESTOS NOTIFICATION TO PROP05ED DEMOLITION ISNOTA BLE TO