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Home My WebLink AboutP2023-0163 - Permits�EWaoRr City of Newport Beach D� ecn Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 U >h S Permit Counter Phone: (949) 644-3288 a c,C/Fp RN�P Inspection Requests Phone: (949) 644-3255 newportbeachce.gov/inspections 111111III 111111111111111111111111111111111111111111111 Plumbing Permit : P2023-0163 Plan Check No: Work Class : Other Issued Date : 05/0312023 Inspection Area : 5 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 : 101 DAHLIA AVE Legal Desc : A TR CORONA DEL MAR BLK C CORONA DEL MAR LOT BLK C IRREG STIR IP IN BLK Description: PLUM SEWER LINE REPAIR ACROSS PROPERTY TO METER Owner: CALIFORNIA INSTITUTE OF TECHNOLOGY Address : 1201 E CALIFORNIA BLVD #202-6 PASADENA, CA 91125 Phone: Applicant: MBTJ BANGERT INC Address : 1591 S SINCLAIR ST #G ANAHEIM, CA 92806 Phone: (714)838-0937 Owner/Builder : Address Phone: Code Edition : 2019 Type of Construction : Building Setbacks Flood Zone Use Zone : PROCESSED BY SPECIAL CONDITIONS: AE, 8 FT; X PI - Private Institutions Contractor : MBTJ BANGERT INC Address : 1591 S SINCLAIR ST #G ANAHEIM, CA 92806 Phone : (714) 838-0937 Con State Lie : 752497 Lie Expire : 05/31/2025 Bus Lie: BT30009851 Bus Lie Expire:06/30/2023 Workers' Compensation Insurance Carrier: OAK RIVER INSURANCE COMPANY Policy No : MBWC440916 W. C. Expire : 1/1/2024 Fire Hazard Zone : NO Occupancy Groups: OWNER -BUILDER 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 checicmark(s) I have placed next to the applicable item(s) action 7031.5. Business and Professions Code. Any city or county that requires a permit Io construct, alter, improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for 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 70DO) of Division 3 of the Business and )fessions Code) or that he or she is exempt from ilcensure, 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 more than five hundred dollars ($500). 1, 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 safe (Section 7044, stress 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 theproperty, provided that the movements 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 )roved for the purpose of sale). 1, 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 Ay 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 am exempt from licensers, under the Contractors' State License Law for the following reason: 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 I a structure that I have built as an owner -builder if it has not boon constructed in its entirety by licensed contractors, I understand that a copy of the applicable law, Section 7044 of the Business and )fessions Code., is available uponrequest when this application is submitted or at the following Aleb site:htip:/hnww.leginfo.ca.govlcalaw.html. (nature of Property Owner or Authorized Agent— Date _ 'ENSED CONTRACTOR'S DECLARATION areby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section 70, j f 4iv sfon 3 of the Business and Prof e, and my license is In full force i effect. License Class License No Date 3 12i Contractor Signature, COMPENSATION DECLARATION rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALrPSNACTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S PEES. hereby affirm under penalty of perjury one of the following declarations: I 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 Code, for lot prformance of the work for which this permit is issued. Policy No.. have 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' to cce canter and policy number are: Policy Number Expiration Date of Agent _ _ _ _ Phone If _ WI carob" that, it. T aperformance 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 egret thrt, if I should bsc6mR ub' ct to I kern` compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. SlgnalLre of Applicant _ UM_ _ Dat 3 ' 23 11C:CL'1RATION FCC,1ADKG t-dM*LI—CY1'dN7-LIl AGENCY hen my a rm urd?-.qerVty afperury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, C,vfl Code). ''.andefs Name Lender's Address By my; ignaturH bAcw, I certify to each of the following. I am the property owner or authorized to act on the properly owners behalf. a I hive read thisapplication and the information vl P d is correct. I agrse l0 a0mply with all applicable city and c ces and state laws relating to building construction. ( / ' I authorize represenlatives of this city or cou. r the above -identified pro r inspection purposes. V�j Z Signature of F_rol ert Owner or Authorized Agent Print Property Owner's or Authorized Age Neme 7tate ACTION DATE BY ARATCON OF COM. IANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY " REGULATIONS PART 61 OF TITLE. 40 AND AQMD RULE 1409 PERMIT'EXPIRED IJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LIEPA ._.__�___._._ PERMIT EXTENDED .... (QMD .... .___i PERMIT FINAL (CD iz ASBLSTOSNOi1FICATION IS NOTAPPLICARLE To CERRFFCATE OF , Y�""� PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE.