The URL can be used to link to this page

Home My WebLink AboutX2019-2787 - Permitst City of Newport Beach- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 - E Permit Counter Phone (949)644-3288 ' Inspection Requests Phone (949)644-3255 Combination Type - SFP Ili iiiiii iiiii iiiii iiiii iiiii giii 7 II COMB Permit: X2019-2787 Project No : Issued Date : 0 910 912 01 9 Inspection Area : 6 oeoo msmo! o co m O ! omoo- E a CC4�! om e o osa! E 040mGW nn O 4 C sos! $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 11 TOTAL FEE: $169.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $169.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: ! 0m4CCrC D moeon 0 OmmCD s0000r E ! O QCl900 ! OflE� PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 6:00 a.m. to 6:00 p.m. No work on Sundays or Job Address: 4 FAYENCE NB Description: SFR -PEX REPIPE Legal Desc.: Owner: GLOGER JOHN & CYNTHIA Contractor: P P S PLUMBING SERVICES INC Architect: Address:.. 4 FAYENCE Address: 1215 W IMPERIAL HWY, STE 212 Address: NEWPORT BEACH CA 92657 BREA CA 92821 Phone: Phone: 714-870-5549 Phone: State Lic: Applicant: P P S PLUMBING SERVICES INC Con State Lic: 805401 Engineer: Address:. 1215 W IMPERIAL HWY, STE 212 Lic Expire:. 03/3112020 Address: BREA CA 92821 Bus Lic: BT30046623 Phone: 714-870-5549 Lic Exp Date: 0313112020 Phone: State Lic: Code Edit : 201$ Worker's Compensation Insurance - Designer: Type of Construction: VB Carrier: SECURITY NATL Address: Occupancy Group:. R31U Policy No: SWC1094044 Added /New sq.ft. Bldg: 0 Expire: 0110112020 Phone: Added /New sq. ft. Garage: 9 No of Stories: 2 Building Setbacks Rear: / Special Conditions: No of Units : 1 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone: N Construction Valuation: $6,000.00 Building Permit Fee: $168:00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee : $0.00 Plan check Fee ; $0.00 Fire Inspection: Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev Investigation Fee: $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm Energy Compliance: $0.00 Grading PC Fee: $0.00 Public Works Department - General Service CA Seismic Safety :.. $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit Disabled Access: $0.00 PAN Plan. Check: $0.00 Grading Bond: Hazardous Mat $0.00 Electrical W $0.00 San Dist: .$0.00 Building Green Fee : $1.00 - Mechanical %: $0.00 NMUSD Fee: $0.00 Plumbinq% .$0.00 oeoo msmo! o co m O ! omoo- E a CC4�! om e o osa! E 040mGW nn O 4 C sos! $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 11 TOTAL FEE: $169.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $169.00 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: ! 0m4CCrC D moeon 0 OmmCD s0000r E ! O QCl900 ! OflE� 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) action 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 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 ifessions 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 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, siness 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 )rovements 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 )roved 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 fly 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). I am exempt from licensure under the Contractors' State License Law for the following reason: 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, 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 ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Proeerty Owner or Authorized Agent Date TENSED COISTRACTOR'S DECLARATION Ireby affirm unJer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) of Division 3 of the Business and Professionsode, and my license is in full force t BfiQct. LigeA9g Class License No Date ttP !2� Contractor Signaturea��'�L�" )RKERS' C6WENSATION DECLARATION !Nita. 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 ($100,000), IN ADDITION TO THE IT OF COMPENSAWONI DAMAGES AS PROVIDED FOR IN SECTION $TO6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. reby.affirm under penalty of perjury one of the following declarations: •. .f!ve and�RinEantain 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 6nca of titewErk for which this permit is issued. Policy No. . ava 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' compensatiol anr',e carrIW2kptl Policy number are: iiiii Policy Number Expiration Date nQ OiAgent. ". Phone # •.ems certify that, in the performance of t work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' com nsation laws of California, and agre if I should become subje o t orke mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. � nature of Applicant i1`7 DatL;Y/ `% .,o n /Ci hereby 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) Lender's Name Lender's Address By 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 ordin and state s relating to building construction. I�CJ'C I authorize representatives of this city or county `y,,,��nt h bove-ide d prop inspection purposes. Signature of Property Owner or Authorized Agent. Print Property Owner's or Authorized Agent's Name ACTION DATE BYCLARATI COMPLIANCE W ODE OF FEDERAL FOR OFFICE USE ONLY - REGULATI S PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED LI I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED DEPA PERMIT EXTENDED QM D PERMITFINAL `( f,,I ASBESTOSNOTIFICATION TAPPLIC TO CERTIFICATE OF Zo�I�j � PROPOSEDD OLITION//4B/C� OCCUPANCYISSUED .1111 GIGNAn1Re ////LJ i!7Y/ii„e�