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HomeMy WebLinkAboutP2023-0037 - PermitsaEWP�RT City of Newport Beach OI Community Development Department- Building Division r n 100 Civic Center Drive, Newport Beach, CA 92660 u Permit Counter Phone: (949) 644-3288 c'4«coaN•P Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Plumbing Permit Plan Check No: Work Class: Other Issued Date : 01/25/2023 Inspection Area : 3 P2023-0037 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 : 2101 INDIAN SPRING LN Legal Desc : N TR 6689 BLK LOT 7 Description: PLMB - REPLACE GAS LINE BETWEEEN METER & HOUSE Owner: TAM LE Address : 2101 INDIAN SPRINGS LN NEWPORT BEACH, CA f Phone: Applicant: EMPIRE PLUMB HEATING & A/C Address : 15632 PRODUCT LN, UNIT E HUNTINGTON BEACF Phone: (714)379-4757 Owner/Builder: Address Phone: Code Edition : 2022 Type of Construction Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone: X Use Zone: R-1-6000 - Single -Unit Residential PROCESSED BY: R) SPECIAL CONDITIONS: Phone ; (714) 37 Con State Lie : 794154 Lie Expire : 04/30/2L �92649 Bus Lie: BT3008( Bus Lie Expire:01/31/2C Workers' Compensatioi Carrier: f INS CO' Policy No: i WSD50: W. C. Expire,::10115/2C Fire. Hazard Zone Occupancy Groups: ites;minimum lot area) • o ©�o �a a�� ao• HEATING & A/C 'UN, UNIT E HUNTINGTON BEACH, CA 92649 OWNER -BUILDER DECLARATION f hereby affirm under penalty of perjury that 1 am exemptfrom the Contractors'State, License Law for thereason(s) indicated below by the cheekmark(s) I have placed next to the applicable items) (Section 7031.5, Business and Professions Code: Any city or county that requites a permit 10 construct, alter, improve, demolish, or. repair any structure, priortaits issuance, also requires the applicantfor, thepermit to file: a signed statement lhat he or she is licensed pursuant to the provisions of the Contractors:' State License Law (Chapter g (commencing with Section 7000) of Division 3 of the Business and. Professions Code) or that he or she is exempt from lidonsure and the basis for the'allaged exemption. Any violation of Section 7031.6 by any applicant fora permit subjects the applicant to a Civil penalty of not more than five hundred dollars ($500). r I, as owner of the property, Cr my employees with wages as their sole compensation, will -do U all of or.0 portions: f the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thrcug 1 employees' or personal effort, builds or Improves the property, provided that the improvements are not intended or offered for sale. If, However, the building or improvement Is sold within one year of cot npleton, the Owner -Builder will have the burden of proving that'll was not built or m mod for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to Construct the project. (Section 70: 0, Business and Professions Code: The Contractors state License Law does not - ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra .for pursuant to the Contractors' State License Law). a p,. I am exempt from licensure under the Contractors' State License Law for the following reason: By my Signature below I acknowledge that, except for my personal residence in which I must Have resided for at [east oni i year prior to completion of the improvements covered by this permit, I cannot legali sail a structure that I have built as an owner -builder if it has not been' constructed in its entirety by licensed contractors. I Inderstand that a copy ofthe applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted drat the following Web site:httpJANww.L mfo.ca.gov/talaw.html. Signature of Property Owner or Authorized Agent Date: LICENSED CONTRACTOR'$ DECLARATION I hereby'affimm under penalty of perjury that I am licensed under provisions of Chapter g (Commencing with: Section 7000 -'of ' isf n3. the Business and P fe •i s ode, • nd my livens "in full force and effect License Class O -9 Licenee:No:2 G/% ` Date 2' Z Contractor Signatur WORKERS' COMPENISATt N D "CLAkATION WARNNe: FAILURE TO SECURE WORKERV COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN P&TIES AND CIVIL FINES OF TO ONE HUNORE LLARS. LS930,0ee1, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FORIN SECTION 3741 OF THE LABOR CODE, INTEREST, AND ATTORNEV`S FEES, I hereby affirm :under penaltyof perjury one of the following declarations: ❑ 1 have andwill 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 in rice: ofiha work for which this permit is issued.. Polioy No. h ve and will maintain wofkars` compensation Insurance, as; required by Section 3700 of the Labor Code, forthe performance of the work for which this permit is issued. My workers' compensatio Insure m er a e camer.and poilcynure; (� , Ca � - t iAA1�— c2K" tl �_�,Number Expiration. Date Name of Agent: Phone # t certify that In the parfonnance of the work for which this permit's issued,1 shall not employ any person in any mann. r so as to become subject to the workers' compensation laws of California, and agra that, if I should become subject to the workers' compensationprovisions of Section 3700 of the Labor Code, i shall forthl iith comply with those provisions. signature of ApplicantNi DECLARATION RE ING -CONSTRUCTIONLENDING AGENCY I hereby affirm under penalty of perjury that there is a construction tending agencyfor the performance of the work for wt 'ch this permit is issued jSection 30g7„Civil Cade):. Lenders Name - Lenders: Address By 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 t1a i ed is correct. 1 agree to comply withal]. epplicable eVty, and county $ er d state laws relating to but ding construction. �� f authorize represantat9vas of this city ar county a aoo fi �` ctiDn purposes. I 1 2,. Si hatura of Plopa Owner or Authoriz a • • • ROM Propattv Owner's or Authorized A er`sNama' ACT{ON.. DATE BY. DECtAR frO FOFC Ai1ANLf 4.'A'RC®BE OF FEDERAL FOR OFICE USEONLY -.... RE ULATi NS PART 6'1 OF TITLE 40AND ALIMA RULE PERMIT EXPIRED Elitu EVAS4S"1WNQTIF4t TION6TO PERMITCAAICELLED Ef'A' • ••• ••: PERMIT EXTENDED UAQMD. PERMIT FINAL ^ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO C€RTIFICA TE 0€ ��1-2/ .PROPOSED 4EMOUTION