HomeMy WebLinkAboutP2020-0156 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
0 G 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 0 0 1 5 6
M Permit Counter Phone (949)644-3288
v
`�<rrou'P
Job Address: 240 NICE LN Bldg: 1 Floor: 3 Suite: 302
Description of Work: PLMB - RJR GAS LINE TO FIREPLACE (120-3073)
Inspector Area: 3 Code Edit 2019
Legal Description: TR 8336 LOT 14 UNIT 117 OF PROJECT LOCATED ON AP 423-011-22
TOGETHER
Owner: JARDINE-GREEN ELAINE
Contractor: OWNER/BLDR
Address: 240 NICE LN #302
Address:
NEWPORT BEACH, CA 92663
Phone:
Phone:
Con State Lic:O/B
Issued Date:10/19/2020
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
PLUMBING Permit: P2020-01
Project No:
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier :
Policy No:
Expire :
FEES
Bathroom Fixtures
Kitchen Fixtures
Misc.
Misc.
Toilet:
0
$0.00
Kitchen Sink:
0
$0.00
Water Piping:
0
$0.00
Roof Drain: 0
Bidet
0
$0.00
Garbage Disp:
0
WOO
Water Softener:
0
$0.00
Grease Trap: 0
Urinal
0
$0.00
Bar Sink:
0
$0.00
Water Heater:
0
$0.00
Grease Interceptor:0
Bath Tub:
0
$0.00
Vegetable Sink:
0
$0.00
Gas up to 4 outlets:
1
$7.00
P-Trap: 0
Shower Stall:
0
$0.00
Ice Maker:
0
$0.00
Gas over 4 outlets:
0
$0.00
Sewer
Wash Basin:
0
$0.00
Dishwasher:
0
$0.00
BackOow up to 2":
0
$0.00
Sewer: 0
Hydro -Mass Tub:0
$0.00
Lndrylfrap:
0
$0.00
Backflow over 2":
0
$0.00
Sewer Alter/Repair:0
Floor Sink:
0
$0.00
Regulator:
0
$0.00
Hose Bibb:
0
$0.00
Sewer Abandon: 0
Floor Drain:
0
$0.00
Lawn Sprinkler:
0
$0.00
Drinking Fountain:
0
$0.00
Additional Fee :
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Other
$0.00
$0.00
Record Mgmt Fee: $0.00
Investigation:
$7.00
Plan Check:
$6.09
Issuance:
$37.00
Supplemental Fee:
$0.00
TOTAL: $57.09 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $57.09
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
I hereby affirm under penalty of perjury that 1 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 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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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).
❑ 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
to an owner of property who builds or improves thereon, and who contrails for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I exempt from licensure under the Contractors' State License Law for the following reason:
By my ignature below I acknowledge that, except for y personal residen which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall.
a structure that I have built as an owner -build it h not been c nst clad in it entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 o the 8 siness and
Professions Code, is available upon request w t ' a "Cation is s mi ed or at a following Web site:http://www.leginfo.ca.gov/calaw.html. ^^11
Signature of Property Owner or Authorized Agent Dat o�
LICENSED CON ACTOR'S ECLARATI N
I hereby affirm under penalty of perjury that I am licensed under provisions Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and m license is in full force
and effect.
License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: 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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 Code, for lh
oerformance of the work for which this permit is issued. Policy No.
❑1 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' compensatiol
'nsurance carrier and policy number are:
mar Policy Number Expiration Date
N e of Agent Phone # ^
I erfify that, in the pert rm n of the work f(oje
h this p rmit is issued, I shall not employ any person in any manner so as to become subject trJ.[{ygworkers' compe sa ion law of California, and ogre
that, if I should becomes the workers'sationrovisions of Section 3700 of the Labor Code, I shall forthwith mbply, ith those provis' n
ature of Applicant l
DECLARATION REGA CONSTRUCTION NDING AGENCY
I hereby affirm under penalty of perjury that there ' construction lending agency for the performance of the work for which this rmit is issued (S tion 3097, Civil Code).
Lender's Name Lender's Address
By my signature below, I certify to each of the foll wing:
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
I agree to comply with all applicable city and counArnces an ate law relatingtobuilding construction.I authorize representatives of this city or county toabove "de tified roperty for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTED ASSES T3S NOTIFV'ATIJN TO:
❑ EPA
❑ AOMD
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIRCARONIS NOT APPLICABLE TO
PROPOSEDDEMOLITION.
PERMITRNAC
Z-
D A-4,
CERPRCATEOF
SIGNATURE:
OCCUPANCYISSUED
F
a)
CO
xz
00
U
�
�
W
N
m a
ID
H
A z
F p
- =
Orn
P4z
o_ v
C)
W
N
Z
�A—o
ya
OC7�°
C)
r
W
a
� A
x 0
MO
z
Waoo
m
F
�c
ICI
zL
�
cu
Uo
>
U
C)
0
L O N
d-0
o a
0cm
o
c ca
�¢ m
y L
4) O
d
��N
TN.rm.
V 4 L
N D °
A V _
V � C
T
m o tf
J °-
j O Oi
r d
r � N
0 ; L
0
0 J
� J'O C
m 7 0 E
T
AS N
L N
N ca a)N = V' N
t ca C y E N J
3_ t
D -2 a. M o
O m m N m G E 0
C:
O) O.L
0� 3 `0o
c J 'D
Ca E T T 3 y ca J
CD a) M'CldT
034 ° a) N 07 x=
c ❑.Md cm`o
T°E>mNoO—=1
L m T O_ N m C y C N
c
° aam i m 3 o c,4. m C>> c 0 L C
a Q m> N 0 0 c E
0 w E> a o o.
G m L J c 7 d m c Ul a) L y N 0 C ID
L C
o c L c Y= y> m w m 7 'O m E
m 9 y N 3 3 3 r= m° o L) C 3 J o O (D L E o
U
Ot$ m E o Nn ° m m v c d t
= a) tm U L m N (D C w C ca c V N 3 N m m 'O J
N 3�°3Nm cn U .� oc •t_m oc mN
m a y J m
w O .> d N m _ L@
J a) N O -O m T .° y m
;� r o_ N T J L m N w U U J .o ap L y m i
Q) aN m° c 3� m� o:° c v d E
a a)c ` 0 ca p m d cc cc N a) 03 ° E m a 3
O L � O. w CD c CD 3 m a) C c O V L N O
N N N m c°/) a) O_CIS
O. L "O m 'O O N ?� a) N 3 U J
U L Q. L .0 CD
U T O T N C 'O N w U m c6 C O N O"
3 0 o m m a)a o o v �- ° 3 a
D_ L C m L 'O m d Y 'O N L w c a) ' m L, N C L d
N y m c U C c0) C C C C °- > C N O j, y w E `) O T
N Eo O o m +Cm _m3o U Jd Tc
O IO M 'O T m U N U U c N D N a) m- —j 3 c N m
c N N> E O E c c N m m m ma E E a) a T
C a) 'O O_ O v- N m 3 .O a) N y a 'j m 4; a1 o L N
w0 Q. N m N °" N -° m r '� T C m U7 J d V fn -O •O N 0_ m N
3 Na c0E_ �_� EmE c�c �Wa) w'�ca wmm
E C U T J m m C p cc N c J T a) L 0 ` — N E
U T 3 .0 d C - m .O .O rmil O a) m. '@_' O ca U Two d N w 0
= C C O J E w. ;` G Y ,O - C T - C C m m U N - N O.
Ew N m m U m C D 'm0 E C `) m m w 0_ °' >, m C 0— C Y ? N
O C T M O J w c E c m N c:- O O N. c
°� 3 an d m m ca
d o ° c°a °) my m e m c� 3 ° G E
N U a)- N G ca L E ° T c ° O- O c 7 a) m`
..N.. m m y co a) 0 E m � L E' •E U N .L-. m C
ccaa 0_ L �"'m _N E C 3 T N m m O 0 N 'm0- L U y N N w0 y N 3
° - o J m O ac O Ur L N ° c9 c 3 ° U J c m c a. -C
c O `N3m rn° c) 0E a) o m a) L
C D• N m d O L c U m p N N m> c U N j� E N U 0 c O C
a) O' O..c E 'O N O. L G O' m U m E O U -O N >. _ m m N
sm m O J y m T C O O O a) - C O. m m L ca N C a)
m m C L m D C m 'O U L .•- a`) E 7 .O T m m N
a O�MC2 vc° cE0 '0 c) -oocN Ecca) cC'
N m� m N� C N m m_'v= NL m m cc OIJ m m 2 ID €-0 ca TC
Lr-
E w E o E m N° c c°
��vOro>, o aE arc v� `mda E Nd�d ym�
z c 9 m Y O_ c a) G O C Q. C a) C N c0 ca
'D m J 3 C =� a° C w0 L
O 7 J L O m o J 'C m J N _J O '0 J !—a,
(0 J E N G 0 J N G
_ m o N L _
U N N m T m O. - C 41 - N m N N ' Y ca- EJ O) T O L _ OW E C E-C y 3 L C
m O �aJ N c T c� �' O a)
Ow 0 m 0� �j_- m m ma y m 3U L
N
M
N
Z
� O
3
N co,
c
O_ O
O
m
CD 0
7
CD
CDm
V Q.
N
CD
� N
o m
J
1 N
y O
N' O
7
W
C J
m
m
7
d
(D
W O n a Z n N y x O S o
N
CD tOn o2 0. 3 `m �nocCD
m J D) N m CD O 7 n
p o N l
o��'c0
c 7 J s C
N Jp o- C C O 7 N y- m -4 CD' 0
O N C 7� z = l- p
Q C a M.
CD °' .Q. A N O O D X [O
n D d 0 N N N CO
(D D CD a �0v v 'n
J 7 y m OT S O
.TT O N CD v .o. p z 3 O
WE ° N CD O
s 0 CD O m
o
a �3� mv_N'< /n� Z,O
C CD T M S ° O O Q m
p �?^�' M. Z UO
J 1
<D 3 O t0 1 CD Vj
y 0 a 0? -«m� m O
f� m tD Q., D
m
CD 0 CD
CD 0 CD
CD z
0 l< 3 0 ° v 0
cr
CD i O O O m
tp .0 CDK N :E m '° O
CD E O
°`<<. .A O a
'OC O i CD a S
1 m m ,". CD O N Q
C, m �Q z
man Z pm rn
QON °CD Cb
a° a O N = a C
CC. D a m
CD CD O m O
i <
Q p m m CD0 CD
C°' a
CD
Z y- an d CD
a o: W
p
o n o
= g r
on
N
3<-
3 m
7 j O N
J
a
m
N`
0 'O
cL
N �' 0 0
CODd
Ol
Q O t1 Cr
RL
N `°<
_ m
O
y O 7 0
�m
y T?
N
C
O
O 7
w `e C tC
C
(D ��
S Q
m C01
C C m 0
m ,�
am;"
,v,,,
Er -
v m
'�
oos"D,Omm�v
m
<.
<mm
..3
tD
J v n`=y
O..
ja
:i'OO O
m �% tD
<
m
N y
0 fCn D M
O C
N O
'N
-3 O:L
d.Sd
N O N
N(n
N ='�
m"'3
» m a
N
to
006.0
ai t0n po-
J <
Q.�i m
ova
q=`ovum
C tD O-
v- C
00
3 N O t
..
O. '�
p 7 N.O
O
d
_S
�.CD
<L
-N
7-o NN
Mm v o
N CD StD
'vt0
m to 3
a
CD CDm
7:
fD n
O C
3 n C 3
O^ O
o
O O
am .c
m y O
�°F$o3CD
m j
C-0 N
,y
M= O,
y'
3 tO
0 01 m 0
to m
01
_ p O
CD
C" 0
1 0
(OD S `<
.0..
O. S
O
m O N' 0
N m C
N t1 m
c 0 'O
m0_ 0.0
m� m C
y' 7
0 j 0
Q O `< tS
O
7N
p,
I< m
O
n. . 0
O
v c
N G
C, N
CD
N O
=w Dl O
v ry Q c
O 7 tp
N G
<
7 m
o
.1 to
0 C 3
C
<
C 'G D O
7
tn'c
C
0 <
J
om m 4
tS
M
O tS
0
M Q' m
m W0 T
m
4!
NCD
O
a 9
�O N
7 0� O
N
CD T
O
m
m tT
D'> 7 ID
6 7 7
tS rZ
m K
v_moti,
m
op,.<m
v ��
M
S N
CD _ N
?, v
O �
3 fD
K m
0
0
m =r
CD
< y
n�
a'
7 O
n N
N 0
o
3
3
3
CD
CD
0
N
J
tD
n
a
O
J
N
n
CD
0
J
N
OS
CD O
1 O
m-0
6. o
a 0
CD
� n
0
0 N
c
= o
m 0
a
c�
C
�I
av
s3
z v
3 m
CD
CD v
17
D/ n
K °O
N J
m 3
-.
0 0
J
n fD
mO
7
v'
< C3
CD
m a
0
o
N Sr
tS C
tp a
O (p
0 m
a 3
N
aDMID
o
a
N
O
c
0
N
1 �m a
nw
o (D
O N �
v c
3 0 < < a
v o 3 m
'= T m 7 m
c a
0 n N CD 0
0 O v N 0.
O J
,cY n2.-
smm
CD D CD <
(D r N N
N
n� CO
° 3
J v d a
�° o
o OW < CD
o w
m a O m p
7
cOO D m
�-v
m0. WJ
m y� S2.
p
d m v
CD Da
!A
o � D
W to
d d
;33.<
C) y N Q
r m
m y O K,
O 7 O
c
CJ71CL J �N
N CD m 0)0
N Dnj v
SSZC m J
G
O_ O m^
-3
�of -o 3 v
V
O p v ?
o m °
< J 3
OS O S
CD , m