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Home My WebLink AboutP2022-0321 - PermitsQ ��WPORT City of Newport Beach Community Development Department- Building Division a p 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 C4L,�oµN�P newportbeachca.gov/inspections Plumbing Permit Plan Check No: Work Class : Other Issued Date : 11/02/2022 Inspection Area : 5 P2022-0321 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 : 506 FERNLEAF AVE Legal Desc : A TR CORONA DEL MAR BLK533 LOT 8 Description: PLUMB -INSTALL 2-WAY SEWER CLEANOUT Owner: KRISTIN RUCK Contractor : SERVICE CHAMPIONS HTG Address : 31961 LINDA LADERA ST YUCAIPA, CA 92399 Address : ' 3150 E BIRCH BREA, CA 92821 Phone: Phone: ,.(714)777-7777 Con State Lie: 799170 Applicant: SERVICE CHAMPIONS HTG Lie Expire: 10/3112023 Address : 3150 E BIRCH BREA, CA 92821 Bus Lie: RM8WC00054221 Phone: (714)777-7777 Bus. Lic. Expire:04/01/2023 Workers'. Compensation Insurance Owner/Builder : Carrier: EVEREST PREMIER INS CO Address : Policy No: RM8WC00054221 Phone : W. C. Expire: 4/1/2023 Code Edition : 2019 Fire Hazard Zone-: NO Type of Construction : Occupancy Groups `UP e Building Setbacks : Front: 15, Side: 3, Side: 3, Rear:.5 e'er Flood Zone: X 8 Use Zone: R-2 - Two -Unit Residential - PROCESSED BY: SPECIAL CONDITIONS a n 6 i0� 9J0 0�4 p�9 Dpb VT y o6V Own !� b Vl tlEe aFe OWNER -BUILDER DECLARATION I. hereby affirm under penalty of perjury that ) am exempt from the Contractors' State License Law for the reasons) indicated Maw (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct;alter, improve, demolish, or rel 1, as owner of theproperty, or my employees with wages as:their sale compensation, will do C_) all of or (_) portions of tl mass: and Professions Code:. The Contractors'. State License Law doeshot apply to an: owner of property who; through ovements are not intended or offered for safe. If;however,. the building or improvement is sold within one year or comp roved for thepurpose of sale). 1, as owner of the property, am. exclusively contracting with licensed Contractors to construct the project (Section 7044, y to an owner of property who builds or improves thereon, and who contracts far the projects with a licensed Contractor t am exempt from luensure under the Contractors' Slate License Law'for the following reason: ny signature below l acknowledge. that, except for my personal residence in which I must have resided for at least one y a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I on essior s Code, Is available upon request when this application is submitted or at the following Web slte:hUp1ANw'wJegm1 I! hereby affirm under penalty of perjury that I am licensed under provisioi and effect: License Class License No, WORKERS'COMPENSATION DECLARATION ind the structure is: not intended oroffered for sale (Section 7044, ;'or personal effort,builds or Improves the properly, provided Instills Owner -Builder will have the burden of proving that It was not built or and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). to full force t510(L006), IN ADDITION TO I hereby affirm under penalty of perjury one of the following declarations. ❑ 1 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 aorman'c" of the work`"' which this permit is issued. Policy No. and wrR mafnlain workers' compensation insurance, as required. by Section 3700 of the. Labor Code.; for the performi nee of the. wort for which this permit is issued. My workers' compensation C cecaniarandpolicynumberare:er Policy Number I Expiration Date Name of Agent. Phone # I certify that, inthe -performance of r for which this ' is issued, I. shalt not employ any person in any manner sa as, o became subject to the workers' compensatlo o laws of California, and agre that, if I should become. sub[ ct to t work _ atian provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r �� Signature of Appricant Dale—. 1 DECLARATION REGAR N NSTR ON LENDING AGENCY li i hereby affirm under penalty ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, C 11 Coda), Lender's Name Len[ By my signature. below, I certify to each of the following: I am the property owner or authorized to act on the property gwne' behalf. I have read this application slid the information l have prow' rs correct. I agree to comply with all applicable city and county ordi dea and state laws refetin t authorize representatives of this city or county tq enter the a a idantifie W., OF TITLE 40 AND,AQMD RULE PERMIT EXPIRED r I L.:I€S IITEUASBBTO5NOTIFICATIONTO :� •�• ••• f°_ °� • D•• � i + i + + ° • � `� PERM)TCANCELLElJ EA PERMIT EXTENDED QM ° ' • • • J ° PERMITFINAL A TOS NOTIFICATION. 15 NOT APPUCAKE TO- CER7/FIEA7'E QF /j� POSED OEA+0L1TION OCCUPANCY ISSUED U SIGNATURE: •:° ° °,,. n • •°. o° w ono ��' e °