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HomeMy WebLinkAboutP2023-0292 - Permits (3)04'. City of Newport Beach 11IIIIII11111111111111111111111IIIIIIIII�IIIIIIIII IICommunity Development Department- Building Division P 2 0 2 3 0 2 9 2 100 Civic Center Drive, Newport Beach, CA 92660 permit Counter Phone: (949) 718-1888 g7Rnewportbeachca.gov/civic Plumbing Permit Plan Check No : PC2022-2014 Work Class : Other Issued Date : 08102/2023 Final Date: Permit Status: Issued Inspection Area : 3 P2023-0292 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: 1945 SANTIAGO DR Description : PLUM INSTALL GAS LINE FOR BBQ Owner: KLOENNE FAMILY TRUST Address : 1100 VIA VERDE SAN DIMAS, CA 91773 Phone: Applicant : DEWALD BEZUIDENHOUT Address : 87 VERMILLION IRVINE, CA 92603 Phone: (949)649-9447 Owner/Builder: KLOENNE FAMILY TRUST Address: 1100 VIA VERDE SAN DIMAS, CA 91773 Phone : Code Edition : 2019 Type of Construction : Legal Dead : N TR 4710 BLK LOT 5 Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone: X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: SPECIAL CONDITIONS: Contractor Address Phone: Con State Lie Lie Expire Bus Lie: Bus Lie Expire: Workers' Compensation Insurance Carrier : Policy No W. C. Expire: Fire Hazard Zone : NO Occupancy Groups: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placednext to the applicable items) iection 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 is permit to fife 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 rofesslons 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 core than five hundred dollars ($500). t, as owner of the property, or my employees with Wages as their sole compensation, will do (_) all of or U Options of the work, and the structure Is not intended or offered for sale (Section 7044, usiness 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 nprovements are not intended or offered for safe. 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 buiit 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 wfio contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law), 5 I am exempt from licensure under the Contractors' State License Law for the following reason: 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 improvements covered by this permit, I cannot legall, all 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 'rofessions Code, Is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmt. dgria Wre. or Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commanding with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force did effect. License Class License No Date Contractor Signature IfORKERS' COMPENSATION DECLARATION 'ARNINO< 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 ($100,000i, tN ADDITION TO T OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES. hereby affirm vender 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 ttte Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for arformance of the work for which this permit is issued. Policy No. 11 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' comperes Isurance carrier and policy number are: artier Policy Number Expiration Date e of Agent A Phone # 1 c diry that, in the pedor f th Werk 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 al Iat, It I should become su ec I,wo ers' compensation provisions of Section 3700 of the Labor Code, I shelf forthwith comply with those provisions. ignature of Applicant._,._ _ _ _ Dated ECLARATION REGARDIN STRUCTIO 'G AGENCY hereby affirm under penalty o p -ury' ihatthere 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 daftly to each of the following. I am the property owner or authorized to act on the property ownA-id ehaif. I have read this aypficalion and the Information I have provid 'seef. I agreD to comply with all applicable city and county or ' asate laws relating to building construction. € authorize reoresematives of this City or county to an r e vnfified property for inspection purposes, r DATE By RDECLAE6UUtATTOMS 00 AN F COM it ATTITLE JE411COD DE OD FEDERAL FOR OFFICE USE ONLY PERMIT EXPIREC LJ I SUBMITTED ASBESTOS NOTI FICATION TO PERM, T CANCEL.. C.7 MEPA PERMIT EXTENDED ❑ggMD rCRM T FINAL inASBESTOS NOTIFICATION IS NOTAPPLICARE TO CERTIFICATE OF qq �(. 11�•p�',. PROPOSED DEMOLITION CCCUTANCYI50E0 �l1 SiGNATUREt.