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HomeMy WebLinkAboutP2022-0009 - Permits�ti �hrkT City of Newport Beach - Building Division 1pil1111111111111111111111111111111������ 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 ` Ar r'��sri�YP�a Job Address: 223 JASMINE AVE Bldg: 1 Floor: Suite: Description of Work: PLUMB - GAS LINE TO BBQ, FIREPLACE, FIRE PIT Inspector Area: k Code Edit 2019 Legal Description: RESUB OF CORONA DEL MAR LOT 23 BLK 136(AND NELY 10FT LOT 21 BLK 1 36 Owner: BRINTON STEPHANIE Contractor: MITCHELL PARKS Address: 223 JASMINE AV Address: 1400 S SUNKIST ST #190 CDM CA 92625 ANAHEIM CA 92806 Phone: Phone: 949-279-7193 Con State Lic:838091 Issued Date:04/2712022 Lie Expire: 05/31/2024 Bus Lie: BT30078593 Processed By: Lic Exp Date: 04130/2023 PLUMBING Permit: P2022-0009 Project No: 0132-2022 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier: NO EMPLOYEES Policy No: Expire : 6A J Do FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 Roof Drain: 0 $0.00 $0.00 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 $0.00 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 $8.00 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 Lndry(Trap: 0 $0.00 Backflow overt": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $38.00 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: $46.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $46.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6,30 p.m. gnd.Raturday from-8:00 a.m. to 6:00 p.m. • •u 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 far 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 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 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://w .leginfo.ca.gov/calaw.htmi. 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 ionn of Division 3 of the Business and rofe e, an y license is in full force and effect. �19 License Class License No Dat L! 2 Contractor Signat NORKERS' COMPENSATION DECLARATION , NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLO R To CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: J I e 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 th e r ce of the work for which this permit is issued. Policy No. av 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' compensatio ance arrt� policy numb pppppp rier \ �` � f lii f r Expiration Date ame of Agent �_ �. �,r+L-/' Phone # 11 certify that, in the perfo of the work f ch th' er it is issued, i shall not employ any person in any manner so as to become subject to the workers' ompensation laws of California, and agre fat, if I should become ject to , orkers' pen on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applican 1'a1j�/ iECLARATION REG NS OterITLENDING AGENCY hereby affirm under p na p 1ury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address y 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 ord n s sta law relating to building construction. I authorize representatives of this city or county to eai the ove-ide if prop y for inspection purposes. innnfum of Prnncrhr nwncr nr Aufhnri7cd Anent V t Prinf Pruner t niuncr'e nr Ai fhnri—H Anent a NnmH. ACTION ©ATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY N FFPF.RA.L REGULATIONS PART 51 OF TITLE 40AND A,ZMD PULE 1403. PERMIT EXPIRED ❑'SU9MfTfEDASBE3TOSNO77RCATIONTO: Ll rPA ❑ AQMD PERMITCANCELLED PERA41TEXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PRC'POSFD DFMOLI TION. PERMIT FINAL CERTIFICATEOF OCCUPANCYfSSUED SrGNATUI:E