HomeMy WebLinkAboutP2021-0147 - Permitsr{ City of Newport Beach - Building Division I 111�1111 III 11p1111111p111111111p111111111111p 11
100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 1 4 7
., Permit Counter Phone (949)644-3288
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PLUMBING Permit: P2021-0147
Project No: 0949-2021
Inspection Requests Phone (949)644-3255
Job Address: 1718 IRVINE AVE Bldg: 1 Floor: Suite: _ ----�
Description of Work: PLUMB/ k
� _ if applicable: `
InspedorArea: 3 rd��S . II refund
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Legal Description: N TR 3082 L T 1l�' Rno or � '� 00`/o ?>.= G;
Owner: MAJESTIC CASSI Cont�o LiC''`' Worker's Compensation Insurance -
Address: 1718 IRVINE AVE Add sS U to �;tiEr;f�nm T`
NEWPORT TB
CA 2660 V C7 r� Policy No:9155131
Phone: 9-4 0-7804 Expire : 03/17/2022
Con State Lic:013
Issued Date:05/07/2021 _.1 is E
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Processed By: • is E 6251
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Bathroom Fixtures Kit Rxt is FAi `` Other
Toilet: 0 $0.00 L
k: 0 0.00 `ater Piping: 0 $0.00 (11GR�glCgrrtrstart(bd) $0.00 $0.00
Bidet 0 $0.00 isp: (9vorso.ear tei/anter Softener. 0 $0.00 Grease Trap: 0 $0.00 $0.00
Urinal 0 $0.00 0 $0.00 Water Heater: 0 $0.00 Grease Interceptor:0 $0.00
Bath Tub: 0 $0.00 Sink: 0 $0.00 Gas up to 4 outlets: 1 $7.00 e: $0.00
Shower Stall: 0 $0.00 ; ou a s: 0 $0.00 Sewer ,�. aio $0.00
Wash Basin: 0 $0,01, r: 0 $0.00 Backflow u to 2": 0 $0.00 Se - Insp, irs 3a '
Hydro -Mass Tub: O $0.00 : 0 0.00 Se Alr ro �.�--mnnna.«�. `'*'
ISs�tance: $37.00
Floor Sink: 0 $0.00 - 0 Sewer Abandon: 0 $0.00 Supplemental Fee: $0.00
Floor Drain: 0 $0.00n er: 0 $0.00 Drinking Fountain: 0 $0.00 Additional Fee: $0.00
TOTAL: $44.00 Plan Check 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.
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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 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 Uusicgss 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 U all of or (_) 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, b s.-a{amproves 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-av ttiehprden 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, and ProfessionsII4de: The ontu;actors' 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 or pursuant to the Oonttators' State LI ns4r;_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 m il r�sided for at le t ',qr yr r to comple(��(�of>t�'� Pp am nts,covered by this permit, I cannot legalll
sell a structure that I have built as an owner -builder if it has not been con s ent!ret b licensed coot c sunderstar�d-(h2�� Aof the a licabl Iaw,Section 7044 of the Business and
Professions Code, is available upon request when this application ad or at the following We site:hftp://www.1�g1ryfo.00gbu/ alaw.html.
Signature of Property Owner or Authorized Agent U-/o bate
LICENSEDCON
I hereby affirm under penalty of pe am licensed ei o ' i hooter 9 (comm iJ,e2cti n 70�00) of Da Business and Profe io Code, and li a is in full force
and effect.
License Class Lice o am it Contractor Signatu .. -�
VORKERS' COMPENSAT N D AKATION
1ARNING: FAILURE TO SECURE2 RS' COMPENSATION COVE 1 LA
:DST OF COMPENSATION, DAMAGES PROVIDE CTION 06OFTHE
hereby affirm under penalty of p rjury a of the lowin ecl tis
1 have and will maintain a ificat of cons to self -Insure for
�e4ormance of the work for which is pe Policy No.
have and d6maintain wo comp nsation i uran requ
isurance carrlkr arg policy n bar re: —i_
a of Aged _ i
ertify that m the performance t worl Ich this permit is issued, I shall
if I should become bject to th I kers' corn ensa�ty/pn rovisions of Sect
iture of Applicant / �
�reby affirm under/penalty of perjury tha there strMltfon lendip ekO
ider's Name ( 1, f,nl rl P�
my signature below, I certify to each of t ollo*ing:
I am the property owner or authorized to ct on the property owner's behalf.
I have read this application and the infor tion I have provided is
I agree to comply with all applicable city ar � edi as and state la
I authorize representatives of this city or co nfygenter above-�o�1-eF
E'EMPLOYER TO CRIMINAL
T, AND ATTORNEY'S F S
n I he
3 Itherabor Code, for
Jeog18q any person i m
I e abor Code, I shall fc
Aperformance of the work
Lender's Address
dating -to bui struction.
3 Erection purposes.
NLTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN OLLARS ($100,000), IN ADDITION TO I
of Industrial Relations as provided forab Sectio 3700 of the Labor Code, for
performance off�t fol�wt}i, permit is is ad. My workers' compensa
Secome subject to the worket�or9a5tiorfaws of California, and
with those provisil j'
permit
AClION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE US€ONL
FEDERAL4ZEGULAjIOI`1JSPART 6f OFT17LE40AND
ACj� L6j mF: 1403s • • � • • • �
PERMIT EXPIRED
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❑; 8UBNTI;EE:AZE%TO ;NOAFICA ION TO:
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PERMIT CANCELLED
❑ AOMD
PERMITEXTENDED
❑ ASBESTOS N07749CA710NIS NOT APPLICABLE TO
PROPOSNDO MOLITIONi
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