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Home My WebLink AboutP2022-0099 - PermitsCity of Newport Beach -Building Division 11111111111111�m1111111111p111111111111111111111 Jill 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 L2 °uavi� Job Address: 1111 CLIFF DR Bldg: 1 Floor: Suite: Description of Work: PLUM SEWER REPAIR Inspector Area: 3 Code Edit 2019 Legal Description: N TR 1219 BILK B LOT 3 Id ° 1S"NSFOR _ Owner: CONWELL KATHLEEN Contractor: E J S CONSTRUCTION Address: 1111 CLIFF DR Address: 31245 CALLE FELICIDAD NEWPORT BEACH, CA 92663 TEMECULA, CA 92591 Phone: Phone: 562-355-0932 Con State Lic:467507 Issued Date:05110/2022 Lie Expire: 01/31/2023 BT30077878 Processed By: 6��_Lie Exp Date: 02/28/2023 PLUMBING Permit: P2022-0099 Project No: 2940-2021 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - ° Carrier:NORGUARD Policy No:EDWC318181 Expire : 02/18/2023 a° ° FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other $0.00 Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 Roof Drain: 0 $0.00 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 $0.00 Urinal 0 $0.00 Bar Sink: 0 $0.00 Water Heater: 0 $0.00 Grease Interceptor:0 $0.00 Bath Tub: 0 $0.00 Vegetable Sink: 0 $0.00 Gas up to 4 outlets: 0 $0.00 P-Trap: 0 $0.00 Record Mgmt Fee: $0.00 Shower Stall: 0 $0.00 Ice Maker: 0 $0.00 Gas over 4 outlets: 0 $0.00 Sewer Investigation: $0.00 Wash Basin: 0 $0.00 Dishwasher: 0 $0.00 Backflow up to 2": 0 $0.00 Sewer: 0 $0.00 Plan Check: $0.00 Hydro -Mass Tub:O $0.00 Lndryfirap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:l $39.00 Issuance: $38.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $0.00 Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 Additional Fee : $0.00 TOTAL: $77.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $77.00 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. 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, priorto 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 U all of or U portions of thei 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 MID,% 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 $ structure? It" I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I uhderstand that a copy of the applicable law, Section 7044 of the Business and Pfofessions-04ote!ls available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. *signature of Propek)66wner or Authorized Agent Date . 0 LICENSED CONTRACTOR'S DECLARATION 'I h&&y affirm ynder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a V Professions Code, and may lie�� Be is in full force �.iceRse Class License No Date l�— ,/ Contractor Signatur I WORKERS' Oq%lefNSATION DECLARATION 'M IKS: 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 ($100,000), IN ADDITION TO THE W; p; �OMPENSATRIN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. rerebyaffirm under dtalty of perjury one of the following declarations: -.bhave and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Ind Jeyfpgriance of fjie work for which this permit is issued. Policy No. ustrial Relations as provided for by Section 3700 of the Labor Code, for the I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pertc{rmance of the work for which this permit is issued. My workers' compensation hs1waace carrier and policy number are: ;arrier Policy Number _ Fvnirvfnn n,ro of Agent I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so t, if I should beco/mee/subject to thew kers' compe.¢;_ation provisions of Section 3700 of the Labor Code, I shall forthwith c mature of ADolic nal t7� %� C :reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which )dens 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 owner's 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 city or county to nter t above -identified property for inspection purposes. nature of Property Owner or Authorized Agent - — /� Print ProDertv Owners or Aufl ACTION I DATE ' I BY CANCELLED PERMIT to become subject to the workers' compensation laws of California, and )ly with those provisopnS. permit is issued (Secti§n 3097, Civil Code). rtucwtf_ t(LUULAI K)NS PART 6f OF THLE40AND AQMD RULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS M017RCA TIONIS NOT APPLICABLE TO PROPOSEDDEMOIITION, OCCUPANCYISSUED I Y I I SIGNATURE:. J B,