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HomeMy WebLinkAboutP2019-0263 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIdIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 9 0 2 6 3 Permit Counter Phone (949)644-3286 Job Address: 7 INVERNESS LN Bldg: 1 Floor: Suite: Description of Work: PLUM/GAS LINE TO FIREPIT X2019-0916 Inspector Area: 4 Code Edit 2016 Legal Description: N TR 7638 LOT 64 Owner: FRIEDR IS & MARILEC Contractor: OLIVE TREE CONSTRUCTION . Carrier: STATE COMP Address 7 IH NESS N Policy No:9169050 Address: 1048 IRVINE AVE, STE #167 Expire : 09/29/2019 m - 92660 NEWPORT BEACH CA 92660 ° Phone:Phone: oo°e 949-378-6456 UPORTBE Con State Lic:523488 Issued DateLic Expire: 12/31/2019 ° ° Misc. Other Bus Lic: BT30028903 Processed BLic $0,00 Exp Date`. 01/31/2020 Grease Interceptor:0 $0.00 yy °•.R•J° P -Trap: 0 $0.00 Record Mgmt Fee: FEES Bathroom Fixtures $0.00 Kitchen Fixtures Misc. Sewer: 0 $0.00 Plan Check: $0.00 Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 $10.00 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 -$0.00 Fee Due at Permit Issuance: $0.00 Urinal 0 $0.00 Bar Sink: 0 $0.00 Water Heater: 0 $0.00 Bath Tub: 0 $0.00 Vegetable Sink: 0 $0.00 Gas up to 4 outlets: 1 $7.00 Shower Stall: 0 $0.00 Ice Maker: 0 $0.00 Gas over 4 outlets: 0 $0.00 Wash Basin: 0 $0.00. Dishwasher: 0 $0.00 Backflow up to 2": 0 $0.00 Hydro -Mass Tub:0 $0.00 Lndry/Trap: 0 $0.00 Backflow over 2": 0 $0.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 TOTAL: $17.00 Plan Check Fee : $17.00 PLUMBING Permit: P2019-0263 Project No : 0625-2019 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance- . Carrier: STATE COMP Policy No:9169050 Expire : 09/29/2019 m - ° oo°e tl ° ° Misc. Other Roof Drain: 0 $0.00 $0,00 Grease Trap: 0 $0.00 Grease Interceptor:0 $0.00 yy °•.R•J° P -Trap: 0 $0.00 Record Mgmt Fee: X O.QU ' Sewer Investigation: $0.00 Sewer: 0 $0.00 Plan Check: $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $10.00 Additional Fee: $0.00 Fee Due at Permit Issuance: $0.00 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 (_) 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.html. 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, and my license is in full force and eWl."' .��\ \/� License Claes••• License No DaI�J'S 'Z;°Sr �9 Contractor Signature'�l°"�-- NQ&KER§-QM4PENSATION DECLARATION YARNING: FAILURE"rb 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirrryunder penalty of perjury one of the following declarations: I have anQ?aill M1raintain 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 th �manceof the-%ork for which this permit is issued. Policy No. h ve an; $ firr6ntain 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' compensatiol rfsur nce carrioand policy number are: Policy Number Date a of Agent :none IF *Rify that! in tp� Aerformance 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 6ecome,suiZject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provial On. Bture of CLARATION REG RDING CONSTRUCTION LENDING AGENCY Heby 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 correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county tg'gjer the ab ems -identified property for inspection purposes. / Q nature of Prnnerfv nwnwr or Authorized Aaenl ice _499 .� /-_!X� Print Prooertv Owner's or Authorized Agent's Nam A is t �S ACTION DATE BY PERMIT EXPIR€D PERMITCANCELLED P€RMITEXTENDED PERMIT FINAL IR Zg q C€RT'FICAT€OF OCCUPANCYISSUED FEDERAL REGULATIONSPART 61 OF TITLE40AND AQMDRULE 1403. i SUBMITTEDASBESTOS N07tFICAT/ON TOr ❑ EPA ❑ AQMD ❑ ASBESTOS M077FICATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION, SIGNATURE: