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Home My WebLink AboutP2020-0109 - Permitsrww'!"Uy- City of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111111 ?rl* 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 0 0 1 0 9 Permit Counter Phone (949)644-3288 . �:lL IeIY`1�•. Job Address: 1106 DOVER DR Bldg: 1 Floor: Suite: Description of Work: PLUMB- GAS LINE Inspector Area: 3 Code Edit 2019 Legal Description: N TR 3000 LOT 12 Owner: RYAN LANCE Contractor: INSTANT LANDSCAPES Address: 1106 DOVER DR Address: 28562 OSO PKWY #D-243 NEWPORT BEACH, CA 92660 RSM CA 92688 Phone: Phone: 949-347-0700 Con State Lic:842586 Issued Date:07110/2020 Lic Expire: 07/31/2020 Bus Lic: BT30053469 Processed By: 1A Lic Exp Date: 12/31/2020 PLUMBING Permit: P2020-0109 Project No : 1133-2020 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier : SIRIUS AMERICA INS Policy NoA 90725-001 Expire : 0811512020 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 $7.00 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: $35.00 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: $42.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $42.00 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 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 L) all of or (_) 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:hftp://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 an a irce and effect. License Class License No Date //�� ``'Contractor Sig ure WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,00(1), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 of the work for which this permit is issued. Policy No. 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' compensation ns �arrier and policy number are: ;(a of Agent certify that, in the pi , if I should become Policy Number Expiration Date which lignature of Applicant )ECLARATION REGAR NG N ON LENDING AGENCY hereby affirm under perfilty of pT ury that there is a constructi ender's Name ly my signature below, I certify t o owing: I am the property owner or authorized to act on the prop neI I have read this application and the information I hav provided i I agree to comply with all applicable city and county ordinances)a I authorize representatives of this city or county to nter the ab g AC77ON DATE PERMITEXP)RED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL �. CERTIFICATEOF OCCUPAPICYISSUED BY issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and is of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. note . `� —1G—Z0 agency for the performance of the work for which this permit is issued Lender's Address behalf. state laws relating to building construction. ientified poorly for inspection purposes. AQMO RULE 1403. ❑ I SUBMITTEDASBFSTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NORRCATLONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: 3097, Civil Code). Date