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Home My WebLink AboutP2021-0558 - Permitsh City of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 5 5 8 D Permit Counter Phone (949)644-3288 Job Address: 24 RUE SAINT CLOUD Bldg: 1 Floor: Suite: Description of Work: PLUMBIREPLACE (E) GAS LINE FROM METER TO MAIN & INSTALL GAS TO BBQ Inspector Area: 4 Code Edit 2019 Legal Description: N TR 7519 LOT 42 Owner: MC DONALD CHRISTOPHER Contractor: RICK DORN CONST Address: 24 RUE SAINT CLOUD Address: P O BOX 10047 NEWPORT BEACH CA 92660 WESTMINSTER CA 92685 Phone: Phone: 714-585-7322 Con State Lic:357535 Issued Date: 12/2171721 .- Lic Expire: 05/31/2023 Bus Lic: BT30074323 Processed By: Lic Exp Date: 02/28/2022 PLUMBING Permit: P2021-0558 Project No: 2355-2020 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier : STATE COMP INS. Policy No:CWC00207000 Expire : 09/28/2022 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/T'rap: 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 190 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 OJO 6tiG DbG GG4 O OJ® 0 O O O e e vc G •e ea b e ae e o a u oe o • u GGb o s G G o e �OOf Ovd V b �.w .,J 890 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). ❑ I, as owner of 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 the purpose of sale). ❑ I, 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.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I 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 and Professions Code cense is in full force and effect. License Class License No DaContractor Signature COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE mTNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for ;e of the work for which this permit is issued. Policy No. have and will nfintaN workers' compensation insurance, rance carrier an Dolicrr number are: of Agent required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Date certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and if I should become sgbjeq�Io the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of CLARATION REGARDING CONSTRUCTION LENDING AGENCY :reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code) Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is comet I agree to comply with all applicable city and county ordinances state ws relating to building construction. I authorize representatives of this city or county o enter the ove-id Ified property for inspection purposes. nature of Property Owner or Authorized Agent / Print Property Owner's or Authorized Agent's Name ACTION BATE BY DECLARATION OF COMPLIANCE WTH CODE OF FOR OFFICE USE ONLY FEbM1_1�0U1%1YT014$ PART yS7 OF`RPLE40ANJD AQMD RUDE 1403. - PERMIT EXPIRED ❑. d SUBAWEDASB"T&NQRVIG ION TO: O❑ ILPA ❑ AQMDD .. PERMIT CANCELLED PE.RMITEXTENDED ASBESTOS aP OPWDaZOOTION,.;,ON(SNQT APPLICABLE TO ••. .. •, .• i s % s + PERMITFINAi aq_ CERTIFICATEOF SIGNATURE. • •+• I.. i