HomeMy WebLinkAboutP2022-0073 - PermitsCity of Newport Beach - Building Division 111111III 11111p11111111111111111111111p1111pp11111
100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 2 0 0 7 3
Permit Counter Phone (949)644-3288
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PLUMBING Permit: P2022-0073
Project No : 1186-2022
Inspection Requests Phone (949)644-3255
Job Address: 330 LA JOLLA DR Bldg: 1 Floor: Suite: g '�'- iie'.
Description of Work: PLUMB - GAS LINE TO BBQ & FIRE PIT " `{ a99�trab
Inspector Area: 3 Code Edit') $O% oc
Legal Description: N TR 444 LOT
Owner: PATRICK ED 1a C7ntractor:PACIFIC LANDSCAPE CONST- to W ,13192t's Compensation Insut2nce -
Address: 330 LA JOLLA DR Address - 22011 COSALA _ Carrier: WIC EXEMPT
NEWPORT BEACH, C 926 MISSION VIEJO CA,j92691 Policy No:(NO EMPLOYEES)
Phone: 949-375-2755 P e 949-233-0927 Expire:
Co tateL 874128 2'`
Issued Date:05/0512022 3 pire 07/31/2023 ' ' ` �O
Bus Lic .,-NEW LICENSE y t N Q' Z
Processed By: za ' Xp Date 05/31/2023
rd V
Bathroom Fixtures
KitcF
Toilet:
0
$0.00
Kitch
Bidet
0
$0.00
Garb
Urinal
0
$0.00
Bar £
Bath Tub:
a
$0.00
Vege
Shower Stall:
0
$0.00
Ice M
Wash Basin:
0
$0.00
Dishu
Hydro -Mass Tub:O
$0.00
Lndry
Floor Sink:
0
$0.00
Regu
Floor Drain:
0
$0.00
Lawn
TOTAL: $46.00
ure�Wate
?,4EES
r� .i'„ rk StafluuI
MisVO vV0
y;
Other
fl
$000'°
"` Water
0
$0.00
Roof rain: 0 $0.00
$0'
,'. 0
$0.00 ,
Water �o ner.
0
$0.00
Grease Trap: 0
0`
-
a. - ,
$6.00
�r:
0
$0.00
Grease r: $Q. pppp�
n 0
$0.64I�or�� Gas up to 4 outlets:
1
$8.00
- rap: �g�$OR6�`1a
ec e.
$0.00
0
$0.00
Gas over 4 outle
0.00
Sewer
vestigation:
$0.00
0
$0.00
B p to 2":
0
$0.00
er: $0.00
Plan Check:
$0.00
,
Backflow over 2":
.00
ter/Repair:0 $0.00
Issuance:
$38.00
0
$0.00
Hos
Sewer Abandon: 0 $0.00
Supplemental Fee:
$0.00
ler: 0
$0
rin ' In:
0
$0.00
Additional Fee : $0.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance : $46.00
PERMITS EXPIRE 180 DA YS 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
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law forthe reason(s) indicated below by the checkmark(s) I,have placed next to the applicable items)
(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).
ZI 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the stru ,nowtended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thro ersonal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement i ar o completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
e'
LJ I, as owner of the property, am
apply to an owner of property whl
❑ 1 am exempt from licensure L
By my signature below I acknowle
sell a structure that I have built
Professions Code, is available
Signature of Property Owner or
I hereby affirm under penalty of
and effect.
License Class
COMPENSATION
1 li as Co to construct the project (Section 71 aIp"M%tffirofessions Code: The Contractors' State License Law does not
Ads or improves thereon, X go r fo ita projects ieerrsad Contractor pursuant to the_C9CbJ �' fLst License Law).
-
r t�q C�,o0���ctors' State Li e o lowing reason: I— soo/0 or E 11 UUVV
th Of persol al resi ence in which I must have residen:Tor $least on year prior to completion of the improvements covered by this permit, I cannot legal
an owner -builder if it has not been instructed in -its entirety by licensed contractors. I understand that a copy of the a aIic law, Section 7044 of the Business and
m re be this ap i ign Is ski milted or at the following Web site http //wwvq i t*VgVWIG
oriz gent `" Dat
IED ONTRr-�TOR'SDEGLARAT).OP{, n_ _
Iry t t I am li sed u olons oChapter 9 (commencing with Sechon17000) of Division 3 of the Business and of o G e, an license is in full force
IARNING: FAILURE TO SECURE WORKERS' Q
:OST OF COMPENSATION, DAMAGES AS PROM
hereby affirm under penalty of perjury
7 I have and will maintain a certific
performance of the work for which this
:1I have and will maintain workers' c
isurance carrier and policy number al
A Agent
tify that, in the perf0 nce of
I should become su act to th
fr�eof ADDlicail'LI�
No
Contractor Signature
TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
1 R WIC 370fi THE f2 ,XTEREST,WIND'RTTORNEY'S FEES.
g de ons: ��
of consent to self -insure for workers' compensation, issued b ire I!Itsy8�la�i , plan
nit is issued. Policy No. pp-�� 1]1i Pl�i iiiiJJ�_ ('� �' `�A
en su e s all
by 'oap 0 f the Labor or a perfonnan a gd teldl which this pe
�6rw..""NN �+ (no wor�C lilt���
Po Number AN Expiration Date
issued, I shall not employ any person
is of Section 370Q_aLt1b&4eei
:reby affirm under perPXlty of perjury th� there is a cons agen
Ider's Name
my signature below, I certify to each of
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 tort
I agree to comply with all applicable city and count rdina an tate,
I authorize representatives of this city or county Ventei abovii
fl
Address
relating to building construction.
oerty for inspection purposes.
Print Property Ownsl
forthwith comply
which this permit is issued (Section 3097, Civil Code).
.ARS ($100,000), IN ADDITION TO THE
7W of the Labor Code, for the
jed-'My workers' compensation
lov.. � s of California, and agree
Date
ACTION
DATF
BY
DECLARATION OF COMPLIANCE NRTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
AQMD RULE 1403.
PERMIT EXPIRED
„2
n ISU3MITTEL'ASBFSTOS NOTIFICATION TO:
❑ EPA
El AGMD
PERMIT CANCELLED
PERMITEXTENDED
G ASDESTOS!IOTI'vC4710N 15 NOTAPPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIAC.4TEO:P
SIGNATJRE:
OCCUPAI)CYISSUE7