HomeMy WebLinkAboutX2020-2683 - Permitst City of Newport Beach - Building Division Illllllllllllllllll�lllllllllllll�lllllllllllllu COMB Permit: X2020-2683
100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 0 2 6 8 3
r"�. ', Permit Counter Phone (949)644-3288 Project NO
s;r 11Y Inspection Requests Phone (949)644-3255
'tytJrara'As Combination Type - MPP PLUM Issued Date: 11/1812020
Inspection Area : 6
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 11/1912023 OR PERMIT WILL BE INVALID
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. No work on Sundays or Holidays
Job Address: 67 ANJOU NB
Description: MFR PEX REPIPE, INCLDS DRYWALL REPAIR (REPL EXPIRED X2017-3789)
Legal Desc.: �l
Owner: RYAN RICHARD BLITHE Contractor: INTEGRITY REPIPE Architect: INSPECT
Address: 6210 W OCEANFRONT Address: 927 CALLE NEGOCIO STE D Address:
NEWPORT BEACH CA 92663
$0.00
SAN CLEMENTE CA 92673
$0.00
Phone:
Phone:
877-473-7473
Phone: State Lie:
Applicant: INTEGRITY REPIPE
Con State Lic:
993925
Engineer:
Address: 927 CALLE NEGOCIO STE D
Lic Expire:
06/3012022
Address:
SAN CLEMENTE CA 92673
Bus Lic: -
BT30066794
.
Phone:
Lic Exp Date:
09/30/2021
Phone: State Lic:
Code Edit : 2016
Worker's Compensation Insurance
Designer:
Type of Construction: VB
Carrier:
CLEAR SPRING PROP & CASUALTY C Address:
Occupancy Group: R21U
Policy No:
CS -WK -000005080-0
Added /New sq.ft. Bldg: 0
Expire:
09/0112021
Phone:
Added /New sq. ft. Garage: 0
PLAN CHECK I
No of Stories: 2
Building Setbacks
Rear: I
Special Conditions:
No of Units : 6 .
Front: I
Bldg Height: 0
Left: /
Bldg Sprinklers:
Right: /
Building Permit Fee: $161.00
Plan Check Fee: $0.00
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access:
$0.00
Hazardous Mat
$0.00
Building Green Fee:
$1.00 -
TOTAL FEE :) $176.49
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Excise Tax:
$0.00
Planning Department -
Additional Fee :
$0.00
Plan check Fee:
Grading Bonds Fee:
$0.00
Fair Share :
Grading PC Consultant:
$0.00
SJH Trans:
Grading Permit Fee:
$0.00
In -lieu Housing Fee:
Grading PC Fee:
$0.00
Public Works Department -
WQ Insp. Fee:
$0.00
Park Dedication : $0.00
P/W Plan Check: $0.00
Electrical %:
$0.00
San Dist: $0.00
%:
$0.00
NMUSD Fee: $0.00
rlechanical
umbing %:
$14.49
Plan Check Fee
: $0.00 Fee
PUBLIC WORK APPR
PLAN CHECK I
APPROVAL TO ISSUE:
Issuance
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Fire Department
$0.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Issuance
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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 `) 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
im 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
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 legal)
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 apilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Prsky-Owner or Authorized Agent Dale
LICENSED CONTRACTOR'S DECLARATION
He+tAB affi m yridec penalty of a un! tFj�t�t Imam licensed under rovisions o ra ter Q c9�nmencin with Secti n 70 f Division 3 of the Business and Prof ss' rrSCode my license is in full force
C V. Y P rl �J _S I p �G L(r g
and effect. License ClAss �, License No Date Contractor Signature
ORI$ERS' COMPEppN,SATION DECLARATION
/INNINP: FAILURE �' %%DRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH ND DOLLARS 15100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
T'here'by affirm undel•penalty of perjury one of the following declarations:
.•.
de and will 0h9intain 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 IN
pe o r nce of the -work for which this permit is issued. Policy No.
av4 and w4rmaintain 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' compensatio
u 9. c «ier AN policy number are:
r' AaOr r7 Policy Number pG G+e 4g 5 664 2 Expiration Date ' Z
ame of Agent "' *'' Phone #
I 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 agre
that, if I should become sub' t to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant D s ��•/����
DECLARATION REGA DING CO UCTION LENDING AGENCY
I hereby affirm under p nalty of perj 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 ordinances and state laws relating to building construction.
I authorize representatives of this city or county to er the abo}�e- entified property for inspection purposes. 1
Sionature of ProDertv Owner or Authorized Ag Y� Print PropertyOwner's or Authorized Agent's Name t Dat �/ A r
ACTION DATE BY ` DECLAON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGU TIONS PART 61 OFTITLE 40 ANDAQMD RULE
1403
PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO
PERMITCANCELLED OEPA
PERMITFINAL U ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF ���� DT�'� PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE:
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