HomeMy WebLinkAboutP2021-0154 - Permitsiyawp„�,r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II PLUMBING Permit: P2021-0154
100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 1 5 a
P Project No : 1082-2021
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 2218 FRANCISCO DR Bldg: 1 Floor: Suite: - vy
Description of Work: PLUM/ GAS TO BBQ & FIRE PIT
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Inspector Area: 3 Code Edit 2019
Legal Description: N TR 3282 LOT 44
able'. nu
Owner: GUY JASON & MACAULAY Contractor: OWNER/BLDR ,.+°'0'" VV�1rt��ompensQafi�n-1rT�fu -
Address: 18 FRA ISCO DR Address: �s� Carrie OC V
NEWPORT EACH, CA 92660:
Phone: 949-514-522 P plre x'
on State Lic:0/B whp(f
Issued ate:05/1412021 Li E t0
Processed B . Lic Exp Dat a� (t
• l,ySJr.• C a
Bathroom Fixtu as Kitc n Fixt res sc. th ti e Q3XI
Toilet: 0 $0.00 Kitchen Sink: 0 0?pOerHeater:
0 0.00 Roof Drain: 0 $0. �i �� $0 0
Bidet 0 $0.00 Garbage Disp: 0 $ 0 f`� 0 $0.00 Grease Tra! is 111 $0
Urinal 0 $0.00 Bar Sink: 0 - $ 0 $0.00 Gr se I er pt �0 d) „`
Bath Tub: 0 $0.00 Vegetable Sink:% 0 Gas up to 4 outlets: 1 $7.00 P-T p: 0 W� l$t1a Record Mgmt Fee: $0,00' (,
Shower Stall: 0 $0.00 Ice Maker: 10 .00 Gas over 4 outlets 0 Se ln0 Investigation: D0
Wash Basin. 0 $0.00 Dishwasher: 0.00 ackfl9u� 2 0 Sewer: 0 $0.00 Pla 0.00
Hydro -Mass Tub: 0 $0.00 Lndry/Trap: rik1jq 142":{`0 $0.00 Sewer Alter/Repair:0 $0.0 ssuagc
Floor Sink: 0 $0.00 Regulator: D I b: �tecdi $0.00 Sewer Abandon: 0.00 S>rpjD a $0 00
Floor Drain: 0 $0.00 Lawn Sprinkler: $ DFgo8hln: 0 $0.00 Additi ee : $O.O�CASp'
TOTAL: $44.00 \ Plan Check fe 0.00 a Du mit Issuance : $44.00
P MITS Mo DA ISSUANCE OR LAST VALID INSPECTION
Construction o Monri ay 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 I am exempt from the Contractors' State License Law forthe 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do J 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
roved 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
ap ly 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).
❑1 am exelnp, from licensure under the Contractors' State License Law he folio g reason:
By my signatu.- ts:ow I acknowledge that, except for my ersonal rest ce hic ust have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall,
sed a strunta•e that have built as an owner -builder' It he be con ucte I ds entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of a Bus ass and
Professioy is Jude, is available upon request w e p do is muted Like following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent _ Dat
LICENSED CONT CT ION
I hereby affi•^ rc'E. penalty of perjury that I a licensed under provisions of Chapter 9 (commencin w' Ivlsion 3 of the Business and rofessions Code, and my license is in full force
any effect.
License Class _ License Date )IJEL'ontractor Signature -
NORI:ERS' Ci[ji E ION b S • a
NARNING: FAILURE to SECU WORKERS' COMPENSATION COVERAGE IS UNLAWF , AND EMPLOYER TO CRIMINAL PEEMpTIESS,.9hnI JW/1F faJP a,4,R THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
6OS r OF COMPENFATI07, DA AGES PR V FA FOR IN SECTION 370 ODE, INTEREST, AND ATTORN EY'S FEES. 8 O I lJ
hereby affirm`unier Fen Ity of e ollowing declarationsa
I have and�will meint in a certificate of consent to self -insure for workers compensation, Issued by the Directo Jodustrial Re rovfde�7r to by Section 3700 of the Labor Code, for th,
ierformance of the work f whi is issued. Policy No. _ t0 IUt I'
�I ave and will maintai work s' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which thi permit is issued. My workers' compensation
nce carrier and polic num rare:
ri Policy Number Expiration Date
f Agent 0 1;� a.i Phone#
I rtify that, in the perfo c t w permit Is issued? I shall not employ any person in any manner so as to become subject to the worker compensation laws of California, and agree
:h , if I should become sub ct to e C Ion vjeo pf Section 3700 of the Labor Code, I shall forthwith comply with those provi ' S.
Signature of Applicant
S (q/Z
DECLARATION REGAR 0 1 END G AGENCY
hereby affirm under pen Ity f erlury that there is a construction lending agency for the perfor nce th wo ilf t CI� of r it d ( n 097d Ci Cake).
Lender's Name Lender's Ad ress 'V _� ,
By my signature below, I certi toe e f IlJRi. Wor4c Stafte {�
am the property owner o auth i, d ac on tIC n a (no
I have read this applicatio and t at on I he p vi
I agree to comply with all a plica le city and c�1w r ' d to I elating to building construction. '
I authorize representatives f this city or county t r he ov dentif property for inspection pur o t,� 14b,
Signature of Property Owner or uthorized A rin Property Owner's or Aut["ggrj Ag it '' V
ACTION
BY
DECLARAT CE MTN - -
FOR OFFICE USE ONLY
L REGU 7LE40AND
❑ I SUBMITTEDASBESTOS NDTIFICA710N TO:
❑ EPA
❑ AOMD
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED
❑ ASBESTOS NORFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED
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