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Home My WebLink AboutP2020-0137 - Permitsw City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1612 HIGHLAND DR Bldg: 1 Floor: Suite: Description of Work: PLUMB GAS LINE TO BBQ & FIRE PIT (S: Inspector Area: 3 Code Edit 2019 Legal Description: N TR 3800 LOT 8 - d Toilet: 0 Owner: AMBER REBECC ont Address: 1612 HIGH R re 1 NEWPOR EACH, L Phone: ®� ° Issued Date: 1010912020 on S E r/�� Processed Bk��1,_ _ C. B ' L Exp Data: 019 Bathroom Fixtures Kit an s _ Toilet: 0 $0.00 itch nk: 0's $0.00 Bidet 0$0.00 arbage Disp: 0 $0. Urinal 0 $0.00 r Sink: Bath Tub: 0 $0.00 V eta i Shower Stall: 0 $0.00 Ice ak0 Wash Basin: 0 . $0.00 Dis ash 0 .00 Hydro -Mass Tub:0 $0.00 Lnd rap: 0 $0.00 Floor Sink: 0 $0.00 Regul tor: 0 $0.00 Floor Drain: 0 $0.00 Lawn rin_kle,/�� 00 4 outle 0 ew Investigation: `0100 0 2" TOTAL: $44.00 / IIP�PI I I ILII SII I ILII VIII IIIII 0IIII1III3 IIIII7 II PLUMBING Permit: P2020-0137 Proiect filo : 1791-2020 c Phone (949)644-3255 �,�"'`,.�'°`r C\G�p'�\tau•- 01�,�,�,..�e�.. , CT®R toWorker's I's Compensation7psu naa; D Carrier: EXEMPT Policy No:\ Expire r .a C f w1CYi z °:c o 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. ke db eti ^i pO ® y FEES $0.00 Roof Roof Drain �+� $0.,06 0 9tel� 0 $0.00 Gr r Ob ��000a $0.00 r nterc0 �gdtlets: 1 . 0 Tr 00 Record Mgmt Fee: a`K`00 4 outle 0 ew Investigation: `0100 0 2" 0 $0.00 Plan Check: $0.00 5w erAlter/Repair:0 $0.00 Issuance: $37.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $0.00 0.00 Additional Fee : $0.00 heck Fee : $0.00 Fee Due at Permit Issuance: $44.00 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 I 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 requiresthe 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 (_) 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). ❑ 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 apply 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 licensure under the Contractors'. State License Law for the following reason: By 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 legall) sell 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 Professions Code, is available upon request when this application is submitted or at the following,Web sit&:http://w".Ieginflo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 o he Business and Professions Code, and my license is in full force and effect.•;•••; - X License Class • License No pr t, '�u' �"ZG' tact or, Signal � e) 4�ERS' QO4MPI,NSATION DECLARATION /�aY(\\ NARNING: FAILURE-MVECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE PbJT dF•COMPENSA'jION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ' herbby affirm uprjQrpenalty of perjury one of the following declarations: - LD•I have and rilltnaintain 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 thi erformance of tike work for which this permit is issued. Policy No. ••• • Vb and wiA4fttain 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' compensatior , ; ra' ce carrier Blind policy number are: - P trier • • •• Policy Number Expiration Date Agent • .@edify that, -in tFie performance of the work for which this. permit is issued, I shall not employ any person in any manner so as to become subjec o the workers' compensation laws of California, and I, if I should AM& subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with tho or istons. nature of App' nt — T CLARATIR�ING CONSTRUCTION LEN MNG AGENCY - Ireby affirm under penalty of perjury that there is a construction lending agency for the performance ofthe work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this cic0 to enter the above -identified property for inspection purposes. f .-y, fQ. nature of Prooertv Owner or Authoriz ent ----tl , T Print Property Owners or Authorized A~/Name T t7ate - ' ACTION DATE BY DECLARATION OF COMPLIA C VIRTNCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TIILE40AND AQMD RULE 1403. PERMITEXPIRED I SUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD " PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS NORRCATIONISNOTAPPLICABLETO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED