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Home My WebLink AboutX2017-1407 - Permitsk,wa ¢ls City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIII \ 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 1 7 Permit Counter Phone (949)644-3288 .-..2Z Inspection Requests Phone (949)644-3255 Combination Type - SFP II COMB Permit: X2017-1407 1 4 0 7 Project No : 2823-2015 Issued Date : 0510112017 „ Inspection Area : 5 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. " 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 ADD 577 SF MECHANICAL ROOMS @ SUB BASEMENT & BASEMENT, RECONFIGURE RET WALLS (X2015-3753) Legal Desc.: N TR 3357 LOT 147 Owner: SHILOH LLC Contractor: DYER J C COMPANY INC Architect: BALL STEPHEN ds ^h C Address: 4615 BRIGHTON RD Address: 1540 S COAST HWY #205 Address: P.O. BOX 9156 CORONA DEL MAR, CA 92625 LAGUNA BEACH CA 92651 LAGUNA BEACH CA 92652 Phone: 949-419-6266 Phone: 714-809-3258 Phone: 949-415-1145 State Lic:C019781 , Applicant: BALL STEPHEN Con State Lic: 586784 Engineer: REZAEI HORMOZ Address: 38 N STONINGTON Lic Expire: 03131/2018 Address: 4164 PORTILLA PL LAGUNA BEACH, CA 92651 Bus Lic: BT98042174 SAN DIEGO CA 92130 Phone: 949-338-2679 Lic Exp Date: 0212812018 Phone: 858-455-0318 State Lic:C-039867 Code Edit : 2016 Worker's Compensation Insurance Designer: Type of Construction: V-B-SPR Carrier: EVERST NATIONAL Address: Occupancy Group: R3/U Policy No: 7600012640 Added /NewfT[ sq.ft. Bldg: 577 Expire: 02/02/2018 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: I Special Conditions: No of Units : 1 Front: I Bldg Height: 0 Left: I Bldg Sprinklers: Right: I I,-_, i ire 7nno- Parklnn 3nanes n Fire Hazard Zone : N Building Permit Fee: $1,766.00 Excise Tax: $121.17 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : $229.00 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: $26.00 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: $5.20 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 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 Building Green Fee : $2.00 Mechanical W $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $2,149.37 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $2,149.37 PROCESSED BY:� PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: 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, priorto its issuance, also requires the applicant for :h3 p3. mit 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 'J•cfesslons 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 hun6red dollars ($500). .1, 1 1. owner or 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 th'e,ourpose of sale). ZI, ac owner cf ".he 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 nioperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 2 I an 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 s.ructure;thLt 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 Profes, ions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CUN TRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) of Division 3 of the Business and Profsvions�.gdda; atyd my ice a is in full force and effect. License Class License No Date S - — Contractor Signature�'�� I �'� NORKERS' COMPENSATION 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$100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: R.I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th mance of the work for which this permit is issued. Policy No. QI Ova and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatioi n ante carrier and policy number are: ;arrier Policy Number Expiration Date Jame of Agent Phone # :1I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre hat, if I should become subject to thew compensations prroovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (� '7 Signature of Applicant��/ 1/$'T JC Date/\ )ECLARATION REGARDING CONSTRUCT17ON LENDING AGENCY 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). _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. 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 count o enter the a n led roperty for inspection purposes. signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam / ajUYbOrCat s �� ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED LJEPA All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall PERMIT EXTENDED LJAQMD be 1n place prior to approval to fill pool/spa & shall remain in place & be maintained for the PERMITFINAL (. S-Z� �! L ASBESTOS NOTIFICATION IS NOT APPLICABLE TO life of the pool. CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: