HomeMy WebLinkAboutP2021-0515 - PermitsCity of Newport Beach - Building Division *P2021-0515*
G„Q 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 601 LIDO PARK DR Bldg: 1 Floor: Suite:
Description of Work: DELTA 1- *ADDITIONAL SCOPE* GASLINE TO FIRE PIT
Inspector Area: 1 Code Edit 2019
Legal Description: TR 7695 LOT 1 UNIT 7E G-1-28 OF PROJ LOCTD ON AP 47-021-29
Owner: 601 LIDO HOME OWNERS ASSOC
Contractor:
Compensation Insurance -
Address: 2472 CHAMBERS RD STE 250
Address:
9261 IRVINE BLVD
TUSTIN, CA 92614
IRVINE CA 92618
Phone: 714-486-3318
Phone:
949-903-2766
Con State Lic:632334
Issued Date:12/10/2021
Lic Expire:
05/31/2023
Bus Lic:
BT30023383
Processed By:
Lic Exp Date:
05/31/2022
PLUMBING Permit: P2021-0515
Project No: 1789-2020
Inspection Requests Phone (949)644-3255
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GEOSCAPE LANDSCAPE CONSTR INC
°Worker's*°
Carrier: STATE FUND
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PolicyNo:9027912-
Expire : 0610112022
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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
LndryfTrap:
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.
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 items)
(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
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 U 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 itwas not built or
improved for the purpose of sale).
I, as owVJr.gf4Je 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 -if 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 exomgtfflpm licensure under the Contractors' State License Law forthe 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 legalp
SVII 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
. Professiorys Cod-, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of RnptV Owner or Authorized Agent Date
.... LICENSED CONTRACTOR'S DECLARATION
I J}Vreby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C d my li a se is in full force
and effect.'"'
'Mense Class • License No Date Z /O Contractor Signature
140Rt(ERS'.CO&WENSATION DECLARATION
WARNING: FAILURt To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOU D S ($100,000I, IN ADDITION TO THE
tOCTV COMPENFATIOAt DAMAGES AS PROVIDED FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
RnatBby afrim uride*r penalty of perjury one of the following declarations: 00
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
xmance 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' compensa
ranee carrier and policy number are:
Policy Number
of Agent
Date
I certify that, in the performance of the work for which this permit is is , I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
t, if I should become subj to the workers' comp sotto pro ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
(n/
ature of Applicant Date '
ICLARATION REGpe It NSy tl t the
GENCY
areby affirm under penalty of perjury that the s a co ruction lending agency for the performance of the work for which this permit is issued (Se on 3097, Civil Code).
ider's Name Lender's Address
my signature below, I certify to each arthe following:
I am the property owner or authorized to act on the property owner's behalf.
1 have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances a late I relating to building construction.
I authorize representatives of this city or county t enter the ab a-i led property for inspection purposes. nn c r_ ��
Inature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Name X ICU Din 1� k + -0 Daj�', lye
ACTION
DATE
DECLARATION OF COMPLIANCE KITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OF TITLE40ANO
AC1 W D RULE 1403:
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AOMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIRCA7ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITRNAL
CERTIRCATEOF
SIGNATURE:
OCCUPANCYISSUED