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HomeMy WebLinkAboutP2020-0014 - Permits�rt City of Newport Beach - Building Division I1pli1p1111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 F - _ Permit Counter Phone (949)644-3288 as Job Address: 4501 TREMONT LN Bldg: 1 Floor: Suite: Description of Work: PLUM SEWER REPAIR Inspector Area: 5 Legal Description: N TR Owner: ALLEN RIC Address: 4501 TREM NEWPORT Phone: Issued Date:01/22/2020 Processed Bv: Bathroom Fixtures Toilet: 0 Bidet 0 Urinal 0 Bath Tub: 0 Shower Stall: 0 Wash Basin: 0 Hydro -Mass Tub:0 nce: Floor Sink: 0 Floor Drain: 0 Code Edit 2019 PLUMBING Permit: P2020-0014 Project No : Inspection Requests Phone (949)644-3255 ) DD --to: 2 LECT TRENCHLESS PIPELINES If applicak ker's Compensation LN `! s: IELD CIRCLE &arri r PLAY I :H, CA 92625 RONA A 9 ❑ 8U% 4f LBo��o Q2d}Lt u P: 51 -7 8 Expire: n State 56 t L e0�clo o to whom:—.— Bu c: B 681 Lie Ex"a-te: 07/31/2020 Kitchen Fixtures Misc. Misc. Kitchen Sink: 0 $0.00 Water Piping: 0 .00 Roof Drain: 0 $0.00 r!3 ge,Qgp: 0 $0.00 Water Softener: $ . eaa Tyaf�g Bar nk. .lop a Heater: EteRs�pto T01 abl fn . M$010 .s� u l to 4 outl s $0.00 P- ra b $0.00 Ice Maker: �, Q $BPP. Gas over 4 out : 0 $0 (MO walatarted) Dishwashe :°110 (S 8�l) Backflow up to 2": 0 $0.00 Sewer: 0 $0.00 Lndry/Trap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:1 $36.0 rllrlp %Iator: 0 $0.00 Hose Bibb: ------G--$040 •-=--SewerkbantfS�' 0 [[awn pnS `kn rer. 0 $0.00 Drinking Fountain: 0 $0.00—AdVMOMI l?fitialS: 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. L�iLI.i1 ice- ° 'ICE GROUPo° ° .. ° $0.00 $0.00 rd Mgmt Fee: $0.00 ligation: $0.00 Check: $0.00 nce: °. . . . ° it $0.00 $0.00 rd Mgmt Fee: $0.00 ligation: $0.00 Check: $0.00 nce: $35.00 1ea4entaf-Fee: $0.00 $71.00 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 U 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 jrpgllicensure 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 legally sell a etructurelhall 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 13t&%Csions C41p, j :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 thereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wi Section 7000) of Division 3. of the Business and ro ns Code, and my license is in full force dQd ene1Clas. •,,' 1^2Z -Z Contractor Signature LlceneOClass License No .Date VMRKERS' COMPJSATION DECLARATION WAedNt?FAILURE TO %ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10D,000), IN ADDITION TO THE CQSTOp COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I I�)reby 4firm urWer pe alty of perjury one of the following declarations: Elt t1201 and will 090tain 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 perfoomance of the work for which this permit is issued. Policy No. - - - - OL 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' compensatior insurance carrier and policy number are: ne of Agent certify that, in the pi , if I should become lature of Applicant _ Policy Number Date For which this permit is issued, I shall not employ any person in any manner so as to become subject to compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisk workers' compensation laws of California, and ZZ- Zd =.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). lder'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 propertyy . I have read this application and the information I have proviI agree to comply with all applicable city and coun ws relating to building construction. I authorize representatives of this city or countyn r td property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name✓CUl S ' ✓ AC77ON DATE BY DECLARATION OF COMPLIANCE MTNCODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AIVD AOMO RULE 1493. PERMITEXP/R€D ❑ I SUBMITTED ASBESTOS N077FICATION TO. ❑ EPA ❑ At,)MD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOIIHC41IONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITFINAL CERTI€KATE OF OCCUPANCYISSUED SIGNATURE: