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Home My WebLink AboutP2020-0020 - PermitsCity of Newport Beach - Building Division 11�1111 111111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 0 0 0 2 0 Permit Counter Phone (949)644-3288 Job Address: 8 ODYSSEY CT Bldg: 1 Floor: Suite: Description of Work: PLUM/WATER HEATER C/O Inspector Area: 3 Code Edit 2019 Legal Description: TR 7817 LOT 1 UNIT 125 OF PROJECT LOCATED ON AP 424-041-01 TOGETHER Owner: ANDERSON MATTHEW Contractor: Address DYSSEY CT Address: • NE PORT BEACH, CA 92663 Ph ne: 626-2 3-9034 .gym.- Phone: Is uad Date:01/31/ Coq State E pue: Bus Lic: PLUMBING Permit: P2020-0020 Project No : Inspection Requests Phone (949)644-3255 INSPECTO Yt cr + 'p zJ h u ` .. Wzk�:_r,'s,bokpensation Insurance - [' l C;I V Carrier :HARTFORD FDEIVT C Polic N0:7 5551 i0 v .12/11/2020 twor s� _ � A I a . 4Na. r,. b � Bathroom Fixtures Kitcherilf Toilet: 0 $0.00 Kitchen Ink: 0 0 Piping: 0 $0.00 Bidet 0 $0.00 GarbageMisp: $ 0 star Softener: 0 $0.00 Urinal 0 $0.00 Bar Sink: Water Heater: 11(117.00 Bath Tub: 0 $0.00 Vegetable link: $0.00 Gas up to 4 $0.00 Shower Stall: 0 $0.00 Ice Maker: 1 $0.00 G 4 $0.00 Wash Basin: 0 $0.00 Dishwasher: s+ 0 00 p (� 0 $0.00 Hydro -Mass Tub:0 $0.00 Lndry/Trap: 0 $ 0 ackfloy�� 0 $0.00 Floor Sink: 0 $0.00 Regulator: i 0 . 0 t9'i;�.Biiltiib: 0 $0.00 Floor Drain: 0 $0.00 , Lawn SprinklerHa 0 $0.00 `-Drinking Fountain: 0 . 0 TOTAL: $52.00 Check Fee: Misc. m ke Dr in: Isr- .00 Gre e 0 g6 e Int �toggk 0.0( P -Trap:: T 0 $0.00 Sewer Sewer:0.00 m $35.00 Fee: $0.00 Fee Due at Permit Issuance : $52.00 80 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.rn. to 6:00 p.m. 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). ❑ 1, 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, 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). ❑ 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 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). ❑ 1 am 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 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://www.leginfo.ca.gov/calaw.htm[. Signature of Proparly,Owner or Authorized Agent Date .0.. LICENSED CONTRACTOR'S DECLARATION J.Vw4y affirmander penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wI Se Ion 70 ) of Division 3 of the Business and Profe ItF3XZRf—ig9lC8n�rce- andeffect. ""' ; License Class License No Dat Contractor Signature WORIZERS' QOMP•ENSATION DECLARATION NARNIN FAILU4$EQURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE HOST.q, COMPENS TlbblrTd DAMAGES AS PROVIDED FOR IN SECTION 370$ OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. , aareGy affirm Jdwoenalty of perjury one of the following declarations: •f ve and wig 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 the Qa ce of the workforwhichthispermitisissuedPolicy No. and JGi{Ie iain workers'compensationinsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is Carrier. .policy number are: :91Yi@I' •�' Policy Number Expiration Date of Agent certify that, in the performance of the work fo aiekihis permit is issued, I shall not employ any person in any manner so aslo become subject to the workers' if I should become subjeyua4hevM rs c 'on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions_ mature of ApplicantDate�(ml CLARATION REGA DIN R G AGENCY -reby affirm under p nalty of at 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 �tont s relating to building construction. I authorize representatives of this city or coueve_i entified roEu*far-inspumon purposes. /� nature of Prooertv Owner or Authorized Aaen Print Property Owner's or Authorized Agent's NamLW ACRON DATE I BY I PERMIT€XPIRED I I I I PERMIT CANCELLED I I I PCCUPANCYISSUED ❑ 1 SUBMITTED ASBESTOS NOTIFICATION T0: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: issued. My workers' laws of California, and