HomeMy WebLinkAboutX2021-2046 - PermitsNr�f City of Newport Beach - Building Division
,T`se 100 Civic Center Drive, Newport Beach, CA 92660
t). Permit Counter Phone(949)644-3288
Ar Inspection Requests Phone (949)644-3255
`:ur��re•' Combination Type - SFP
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COMB Permit: X2021
Project No : 1777-2021
Issued Date : 08104/2021
Inspection Area : 5
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 08/04/2024 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 Ho/ides
Jab Address:
Description:
4615 BRIGHTON RD N13
SFR ADD RIDGE CAP TO EXTG ROOF (X2021-1008)
r y�
Legal Desc.:
N TR 3357 LOT 147,E
Owner:
SHILOH LLC Contractor:
DYER J C COMPANY INC Architect: ELENES CARLOS
Address:
4615 BRIGHTON RD Address:
1540 S COAST HWY #205 Address: 17871 MITCHELL N #150
CORONA DEL MAR, CA 92625
LAGUNA BEACH CA 92651 IRVINE CA 92614 d�
Phone:
949-419-5266 Phone:
714-809-3258 Phone: 949-955-3282 State Lic:C017463
Applicant: SHILOH LLC
Address: 4615 BRIGHTON RD
CORONA DEL MAR, CA 92625
Phone: 949-419-5266
Code Edit:
2019
Type of Construction:
V-BSPR
Occupancy Group:
R3/U
Added /New sq.ft. Bldg:
0
Added /New sq. ft. Garage:
0
No of Stories:
1
No of Units :
1
Bldg Height:
0
Bldg Sprinklers:
Y
Flnnd 7nne:
VE
Construction Valuation:
Building Permit Fee: $739.00
Plan Check Fee: $642.93
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$4.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$2.00
TOTAL FEE: $1,439.93
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Con State Lie:
586784
Engineer:
Lie Expire:
03/31/2022
Address:
Bus Lie:
BT98042174
Lie Exp Date:
02/28/2022
Phone:
Worker's Compensation Insurance
Designer:
Carrier:
EVERST NATIONAL
Address:
Policy No:
7600012640201
Expire:
01/01/2022
Phone:
Building Setbacks
Rear: /
Special Conditions:
Front: /
Left: /
Right: /
Excise Tax:
$0.00
Additional Fee :
$0.00
Grading Bonds Fee:
$0.00
Grading PC Consultant :
$0.00
Grading Permit Fee:
$0.00
Grading PC Fee:
$0.00
WQ Insp. Fee:
$0.00
Electrical %:
$0.00
Mechanical %:
$0.00
Plumbing %:
$0.00
Plan Check Fee
State Lie:
0 Fire Hazard Zone : N
Planning Department-
Fire Department
Plan check Fee : $52.00
Fire Inspection:
$0.00
Fair Share : $0.00
Fire Plan Rev
$0.6d
SJH Trans : $0.00
Demolition Fee
In -lieu Housing Fee : $0.00
Building Dept Adm
$0.00
Public Works Department-
General Service
$0.00
Park Dedication : $0.00
Refund Deposit
$0.00
PNV Plan Check: $0.00
Grading Bond:
$0.00
San Dist: $0.00
NMUSD Fee: $0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance :
$1,439.93
PUBLIC WORKS APPROVAL:
n
r✓
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
he 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
Irofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 byanyapplicant for a permit subjects the applicant to a civil penalty of
lot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness 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
Tlprovements 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
Tlproved 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
Ipply 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 Iicensure under the Contractors' State License Law for the following reason:
3y 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 that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understandthat 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:hftp://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 Section 7000 Division 3 of the Business and Professions e, a my lice se full force
Ind effect. License Class License No Date -� Contractor Signature
VORKERS' COMPENSATION DECLARATION e,
v
✓ARNING: FAILURE TO E=„URE 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 ATTORNEYS FEES.
'nerehv affirm under penalty of perjury one of the following declarations:
1 have and w!'I r.icintain 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
,-�(nrmznce of the work for which this permit is issued. Policy No.
ave and will r (aintain 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'
anca carrier Lrd policy number are:
Policy Number
of Agent
Date
-cr'if7 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
I, if I should become Ru ct to t workers' compensa J ZZO—Visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. L 1 r1
namrrof Applicant lG Date-
CLARATION' REQ F;DING CONSTRUCTION ON 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 coun ordinances and state laws relating to building construction.
I authorize representatives of this city or count nter Dove/-ident. ii�d pr—operty for inspection purposes. .� A
nature of Prooertv Owner or Authorized ADent , L,-4/ II Print Prooertv Owner's or Authorized ADent's Name Z/.�C�C� L7CS�r�(&XT Date � q"o�.k
ACTION DATE BY DECLARA ION OF COMPLIANCE
61 TITLE 40 WITH
CODE OF FEDEFEDERAL I FOR OFFICE USE ONLY RULATIONS
PERMITEXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL QnJ A ESTOS NOTIFICATION IS NOT
CERTIFICATE OF P O ED DE LITION /
OCCUPANCY ISSUED RIrNA I 1 L'