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Home My WebLink AboutX2021-1008 - PermitsQ,W,•hgj,% City of Newport Beach - Building Division *X2021--1008* COMB Permit: X2021-1 4 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 2823-2015 Permit Counter Phone (949)644-3288 u A Inspection Requests Phone (949)644-3255 Issued Date : 04128/2021 r:drry,q�x,.+3 Combination Type - SFP �PECTO Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0412612024 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: 4615 BRIGHTON RD NB Description: SFR REROOF REPLACE TILE W/ NATURAL TILE (NO ESR #) 11.98 LBS 92 SQS Legal Desc.: N TR 3357 LOT 147 Owner: SHILOH LLC Contractor: DYER J C COMPANY INC Architect: Address: 4615 BRIGHTON RD Address: 1540 S COAST HWY #205 Address: "" CORONA DEL MAR, CA 92625 LAGUNA BEACH CA 92651 " Phone: 949-419-5266 Phone: 714-809-3258 Phone: State Lic: ' 3 Applicant: SHILOH LLC Con State Lic: 586784 Engineer: Address: 4615 BRIGHTON RD Lic Expire: 03131/2022 Address: CORONA DEL MAR, CA 92625 Bus Lic: BT98042174 " Phone: 949-419-5266 Lic Exp Date: 02128/2022 Phone: State Lic: Code Edit: 2019 Type of Construction: V-B 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: Construction Building Permit Fee: $343.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $7.00 TOTAL FEE: $350.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: EVERST NATIONAL Policy No: 7600012640201 Expire: 0110112022 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Designer: Address: Phone: Special Conditions: Fire Hazard Zone : N 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 Plan Check Fee : $0.00 Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $350.00 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 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 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). I am exen.pt Sam Iicensure under the Contractors' State License Law for the following reason: By my signatu-e tclow 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 legally 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 PrOTe5SI0nS Code. is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under,penaity of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 0) of Division 3 of the Business and Prof ode, nd i nseis II force and ef`ect. License Mass License No Date Contractor Signature' WORKERS' COMPENSATION DECLARATION WARNINj: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH USAND DOLLARS (5100,000), IN ADDITION TO THE C:,S. OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 a.rtaov 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 th( ubnormvnce of the wofc for which this permit 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 which this permit is issued. My workers' Vance carrier and policy number are: Policy Number of Agent Date I certify 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 hat, if I should beco SUNS o orkers,'. p nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant/>'i Date )ECLARATION REG�RUCTION LE DING AGENCY herebyraffirm under penalty o perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Ci 1 Code). -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 property owner's behalf. I have read this application and the information I have provided is correct. `��''kj� jbpo I agree to comply with all applicable city and co ty ordinances and state law relating to building construction. �l.t-� r I authorize representatives of this city or co 0 ab.denti b arty for inspection purposes. —�; signature of Property Owner or Authorized Agent ov Print Property Owner's or Authorized Agent's Nam ' - Date ACTION DATE BY Y D RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 I SUBMITTED ASBESTOS EPA PERMITEXTENDED CERMFICATAL *3-1 12� POSE OS OT EIC& ON IS N TA ICABLE TO OCCUPANCY ISSUED SIG TU G