HomeMy WebLinkAboutP2021-0549 - Permitss�°Ifs. City of Newport Beach - Building Division11111111111111111111111111111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 5 4 9
Permit Counter Phone (949)644-3288
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Job Address: 33 VERNON Bldg: 1 Floor: Suite:
Description of Work: PLUMB- GAS LINE TO BBQ/FIRE PIT
Inspector Area: 6 Code Edit 2019
Legal Description: N TR 15333 LOT 5
Owner: SIDEBOTHAM ERIC
Contractor:
INSTANT POOLSCAPES
Address: 33 VERNON
Address:
833 DOVER DR #24
NEWPORT COAST, CA 92657
NEWPORT BEACH CA 92663
Phone:
Phone:
949-795.0648
Con State Lic:1009644
Issued Date:1211512021
Lic Expire:
12/31/2021
Bus Lic:
BT30053469
Processed By:
Lic Exp Date:
12/31/2021
PLUMBING Permit: P2021-0549
Project No: 2933-2021
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier: WC EXEMPT
Policy No:(NO EMPLOYEES)
Expire :
FEES
Bathroom Fixtures
Kitchen Fixtures
Misc.
Misc.
Other
Toilet:
0
$0.00
Kitchen Sink:
0
$0.00
Water Piping:
0
$0.00
Roof Drain: 0
$0.00
$0.00
Bidet
0
$0.00
Garbage Disp:
0
$0.00
Water Softener:
0
$0.00
Grease Trap: 0
$0.00
$0.00
Urinal
0
$0.00
Bar Sink:
0
$0.00
Water Heater:
0
$0.00
Grease Interceptor:0
$0.00
Bath Tub:
0
$0.00
Vegetable Sink:
0
$0.00
Gas up to 4 outlets:
1
$8.00
P-Trap: 0
$0.00
Record Mgmt Fee:
$0.00
Shower Stall:
0
$0.00
Ice Maker:
0
$0.00
Gas over 4 outlets:
0
$0.00
Sewer
Investigation:
$0.00
Wash Basin:
0
$0.00
Dishwasher:
0
$0.00
Backflow up to 2":
0
$0.00
Sewer: 0
$0.00
Plan Check:
$0.00
Hydro -Mass Tub:0
$0.00
Lndry/Trap:
0
$0.00
Backflow over 2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
$38.00
Floor Sink:
0
$0.00
Regulator:
0
$0.00
Hose Bibb:
0
$0.00
Sewer Abandon: 0
$0.00
Supplemental Fee:
$0.00
Floor Drain:
0
$0.00
Lawn Sprinkler:
0
$0.00
Drinking Fountain:
0
$0.00
Additional Fee :
$0.00
TOTAL:
$46.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance : $46.00
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.
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OWNER -BUILDER DECLARATION ..y
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 Iicensure 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 Iicensure 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 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a dons ode, and myilL2nse-is in full force
and effect. YY� `�._ � —�
License Class License No Date] 1 Contractor Sig tg_ure _ _
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 ($100,000(, IN ADDITION TO THE
-OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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 the
)erformance of the work 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'
rance carrier and policy number are:
Policy Number
if Agent —
tif that, in the ormance of the wo <for which
I should beco subject to the worker ' com
Y p
ire of ADD11Can " /
Date
ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
hereby affirm under penalty o pe " at the s�nstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name _� Lender's Address
y my signature below, I certiffto-15ach of the following:
I am the property owner or authorized to act on the pro
have read this application and the information I e pi
1 agree to comply with all applicable city and c my ordi
I authorize representatives of this city or cou y to enter
's behalf.
correct.
id state laws relating to building construction.
identified property for inspection purposes.
Print Property Owner's or Authorized
ACTION
DATE
BY
DECLARATIO 0 OF COMPLIANCE IAITH CODE OF
FOR OFFICE USE ONLY
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•••
• • • ••• •••_LED9A4L17rGVLATIONS
•••
PART BI OF TIRE 40 AND
AQMD RULE 1403.
PERMITEXPIRED
••• •
❑ I SUBMITTEDASBESTOS NOTIFICATION TO:.
❑ EPA
❑ AQMD
PERMIT CANCELLED
• •
• • • • • •
PERMITEXTEN'DED
❑ ASBESTOS NORACARONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
22-Z • • •
• • • • •
CERTiFiCATEOF
•
• • • • • • •
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SIGNATURE:
OCCUPANCYf55UED