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HomeMy WebLinkAboutP2023-0545 - Permits�EvweoRr City of Newport Beach Community Development Department- Building Division F 100 Civic Center Drive, Newport Beach, CA 92660 U S Permit Counter Phone: (949) 718-1888 cqC/F00.N�P newportbeachca.gov/civic giiiiiiiiii II Plumbing Permit Plan Check No : 1949.2020 Work Class : Other Issued Date : 1113012023 Final Date: Permit Status: Issued Inspection Area : 1 P2023-0545 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 1 BAY ISLAND Legal Desc : S TWP 6 RGE 10 SEC 34 Description: PLUMB INSTALL GAS LINE FOR BBQ AND FIRE PIT Owner: BERNE EVANS Address : 1 BAY ISLAND NEWPORT BEACH, CA 92661 Phone: Applicant: PENINSULA HOME BLDRS INC Address: 101 SHIPYARD WAY #A NEWPORT BEACH, CA 92663 Phone: (949)723-0147 Owner/Builder : Address Phone: Contractor : PENINSULA HOME BLDRS INC Address : 101 SHIPYARD WAY #A NEWPORT BEACH, CA 92663 Phone : (949) 723-0147 Con State Lie : 842666 Lie Expire : 07/31/2024 Bus Lie: BT30008665 Bus Lie Expire: 01 /31/2024 Workers' rr1pgnoil Insurance Carrier: *j►/��% Policy No : W. C. Expire: Code Edition : 2022 Fire Hazard Zone : NO Type of Construction : Occupancy Groups Building Setbacks : Flood Zone : AE, 8 FT Use Zone : RM - Multiple Residential, RM - Multiple Residential, RM - Multiple Residential, RM - Multiple Residential, OS - Open Space, OS PROCESSED BY SPECIAL CONDITIONS: Open Space, RM - OWNER•BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items) ;action 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 ie 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 70D6) of Division 3 of the Business and rofessions Code) or that he or she is exempt from licensors 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 A more than five hundred dollars ($500). 11, 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, useess and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the properly, provided that the nprovements 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 nproved 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 pply 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). I I are exempt from 116ensure under the Contractors' State License Law for the following — _ __._,____-------- y 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 legalb of a structure that I have built as an owner -builder if it has not been conslructod in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and rofessions Code., is available upon request when this application is submitted or at the following VVeb site:http:Uww'vv.leginfo.ca.govlcalaw.html. gnature of Property Owner or Authorized Agent _ ._._.___ _ _ Date .ICEN'.SED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions e is in full force no effect License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION 'ARNING: 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 ($011.000), IN ADDITION TO THE OST 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: I 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 Cade, forth arformance of the work for which this permit is issued. Policy No,. 71 have and will maintain workers' compensation insurance, as required by Seclion 3700 of the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensabo isurance carrier and policy number are'. Policy Number Date to of Agent 1-none s certify that, in the performance of the work for which this permit is issued, 1 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 to th ' rk mp/eennnsso' Sn provisions of Section 3700 of the Labor Code,. I shall forthwith comply with those provisions. lature of Aoolicant '/'/`c=-v/ (_. ! Date,_---! hereby 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). enders Name Lender's Address ly my signature bulow, ; certify to each of the following: I am.the property ov,: ner or authorized to act on the property owner's behalf. I Have read tl-s app'ication and the information I have provided is correct. I aqroe to comply w'th all applicable city and county ordinances and state laws relating to building construction. I auliorize repr:.sentattves of this city or county to enter the ab to y for inspection purposes. / 1i,,inature of Pre pert Owner or Authorized Agent Print Property Owner's or Authorized Agent s Name 61 4CTION I DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND ACME) RULE PEWMtT tKPIREO U I SUBMITTED ASBESTOS NOTIFICATION TO Q WCPA nggvITEXTEN➢Cw QAOMD CERTIFICATE OLI �fPMtr FfFJAl 10' �, ❑ASBESTOS NOTIFICATION IS NOf APPLICABLE TO P2 OPOSED DEMOLITION OCCUPANCYISSUED I SIGNATURE: ��� Date (!r