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HomeMy WebLinkAboutP2022-0110 - PermitsCity of Newport Beach -Building Division 'P2022-0110' _S G 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 7 rat+rnu+''X Job Address: 40 CABRILLO ST Bldg: 1 Floor: Suite: Description of Work: SFR PLUMB: GAS LINE FOR BBQ Inspector Area: 1 Code Edit 2019 Legal Description: N TR 15935 LOT 69 Owner: HORTON MICHELLE Address: 40 CABRILLO ST NEWPORT BEACH, CA 92663 Phone: Issued Date:05/18/2022 Processed Contractor: OW N ERIBLDR Address: HORTON MICHELLE OIB FORM ATTACHED Phone: 714-470-3833 Con State Lic:OIB Lic Expire: Bus Lic: Lic Exp Date: PLUMBING Permit: P2022-0110 Project No : Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance Carrier: Policy No: Expire: 0 0 z z "ri C% Z" -I rt� G�1b�6 0 ,a 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 t": 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 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 n more than five hundred dollars ($500). WJ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Cade: 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-Builderwill 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 Iicensure under the Contractors' State License Law for the following reason: By my signature oelow 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 lega111 sell a structurd Jac I have built as an owner -builder if it has not been cpnstructed in its gntirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and ,7,- f;:ssions Ccde, is available upon request when this ,��yv,,'����`ion is ubm'tied or , h folio 'n Web site:hftp ://www.leg info.ca.g ov/calaw.htmi. Signature of Prope t;, Owner or Authorized Agent ie / ' 1 Ll ., Date LICENSED CONT CTACLARATION I hereby affirm Under nenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force anu effect. ' ` ' ice:ire Class License No Date Contractor Signature WC:FIi ERS' GQMPENSATION DECLARATION ,iARN„N.i: 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 I$100,0001, IN ADDITION TO THE r'QST QJ r.OMPENSAT0N, 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: 2 ',ia.e 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 tht oerfo-nance of 'he wore' 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 of Agent 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 subje"y he workers' compensatiop provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of Applicant CLARATION REGARDING CONSTRUCTION LENDING AGENCY rreby 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. 1 have read this application and the information I have provided is correct. I agree to comply with all applicable city and county or nces and state laws relating to building construction. I authorize representatives of this city or county to enter ove-enti'ed prop fo�rinspection purposes. A,J`� I �6�7v1a nofii o nF P—nnH„ n,.,,,or „r A, eb.ri nd Annnl X / i L �tJ /A /3Tnrl,a PrnncH„ n,.,nmem ,.r A, a6nri nH AnnnVc Kimmm iCIV� (--� ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403. PERMIT EXPMED ❑ I SUBMTTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PER441TEYTEAIDED ❑ ASBLSTOSNOBHCA70NISNOTAPPLICABLETO PROPOSED DEMOLITION. PERMITFINAL G CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: \ z � \ \ { \) /§0m z-f± D °>z PLO §88& az`« Q °3]] / wda: §K( S � /\z � � \ u \ c ƒ (3) q \\ \\\\/ Bm �:0 o W _@ t_0 LU o= =0.90 e� §# ¥0-==o/ Lu \ \\\\ � zd j §ƒ�»/ �§ �_ &§(a\/ a)� 0 ]2 ƒ\ \\k\\a �z =\ 3/�\_\ / g � = \ƒ \ / ! 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