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HomeMy WebLinkAboutP2021-0195 - Permitswt,p City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1221 SURFLINE WAY Bldg: 1 Floor: Suite: Description of Work: GASLINE TO BBQ & FIRE PIT (S2021-0150) Inspector Area: 6 Code Edit 2019 Legal Description: N TR 6113 LOT 9 Owner: WILD FOREST Contractor: INSTANT POOLSCAPES Address: 1221 SURFLINE WAY Address: 833 DOVER DR #24 CORONA DEL MAR, CA 92625 NEWPORT BEACH CA 92663 Phone: Phone: 949-795-0648 Con State Lic:1009644 Issued Date:06/28/2021 Lic Expire: 12/31/2021 Bus Lic: BT30053469 Processed By: Lic Exp Date: 12/31/2021 PLUMBING Permit: P2021-0195 Project No : 1459-2021 Inspection Requests Phone (9; Worker's Compensation Insurance - Carrier: WC EXEMPT m..e Policy No:(NO EMPLOYEES) °mmmme Expire : e omom mama^� 0 o m o - co 0 ° e o e e• n em m mm 0o m . e e m ommoo mm m o mmmoo FEES om0000 Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other mm m o Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping:0 $0.00 Roof Drain: 0 $0.00 40.0e Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 Kbb-° 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 Lndryfrrap: 0 $0.00 Backflow overt": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $37.00 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: $44.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $44.00 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 1. -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 Iicensure 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 Iicensure 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 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.htmi. Signature of Prclpaity Owner or Authorized Agent •••••• LICENSED CONTRACTOR'S DECLARATION L4EViI1iy affirm y*j penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with WtIon 7000) of Division 3 of the Bus' and Prof ssions Co , and my license is in full force • and effect. • • • 6�z��Z License Class • • • License No Date Contractor Sig WORKERS' COMPENSATION DECLARATION WARNING: 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 ($100,0001, IN ADDITION TO THE COSt j)FCOMPENSATION, CIAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1•11pjP•gv affirm W tlgf penalty of perjury one of the following declarations: ©f 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 perfr,7inpance of the work for which this permit is issued. Policy No. • • •• • I hav@• and AllQfair:ain 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: Cjlft(ep • • •y+� Policy Number Expiration Date u - rtify that, in the performance he wor or 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 , if I should become subject t the workers' dpm rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. f nature of Applicant - Date Z 1 CLARATION REGARDMG U TI LENDING AGENCY areby affirm under penalty o re is a constru ing 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 GIs correct. / ?—Z I agree to comply with all applicable city and count ordinances all state laws relating to building construction. 6 1 authorize representatives of this city or county to a above-i emined pro oses. . f„rc . f o... ,, n,.—, „r A„}hnri,.H Ancnf Print Prdoedv Owner's or Authorized Aoent's Name �� � � `WT Date / AC77ON DATE BY FEDERAL REGULArIONSPART 87 OFT17LE40AND EXPIRED AQMD RULE 1403. ❑ 1 SUBMITTED ASBESTOS N077FICATION TO.' CANCELLED ❑ EPA :EXTENDED ❑ AQMD' ❑ ASBESTOS NORRCAT CIN IS NOT APPLICABLE TO FINAL /0 -IV -2/ /__K PROPOSED DEMOLITION. OCCUPANCYf SUED I SIGNATURE: