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Home My WebLink AboutP2022-0102 - PermitsCity of Newport Beach - Building Division �* Ae 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 r'�C iP�114N1a Job Address: 1115 ESSEX LN Bldg: 1 Floor: Suite: Description of Work: PLMB - GAS LINE TO BBQ Inspector Area: 3 Code Edit 2019 Legal Description: N TR 3000 LOT 43 Owner: LAUER MATT & ANDREA Contractor: WEST HILLS MASONRY Address: 1115 ESSEX LANE Address: 18195 MCDURMOTT E STE B NEWPORT BEACH, CA 92660 IRVINE CA 92614 Phone: 614-893-3511 Phone: 714-519-5009 Con State Lic:920870 Issued Date:05/11/2022 Lic Expire: 0913012022 Bus Lic: BT30072553 Processed By: Lic Exp Date: 07131/2022 PLUMBING Permit: P2022-0102 Project No : 0126-2021 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier: SERVICE AMERICAN INDEMNITY CO Policy No:SAAWC000064700 Expire : 08101/2022 i 4 O-S r-t' T- r% "may mil FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 Roof Drain: 0 $0.00 $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: 1 $8.00 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:0 $0.00 Lndry/Trap: 0 $0.00 Backf ow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 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: $46.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $46.00 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 ne>gt 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 U 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-Builderwill 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). ❑ 1 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 site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent 13ate 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 of the Busin s and Pr ssio de, and y license is in full force and effect. License Class License No Date 5 u 7... Contractor Signatu NORKERS' COMPENSATION DECLARATION 'ARNING: 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 DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: id will 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 of the work for which this permit is issued. Policy No. and will maintain 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' carrier and policy number are: Policy is of Agent certify that, in the p rformance o the wort/ fo which if I should becom subject tot workers ompen: lature of Applicant hereby affirm under penalty of perjury that there is a constructi ender's Name y my signature below, I certify to each of the followin I am the property owner or authorized to act ofty -rope" I have read this application and the informatioave prov I agree to comply with all applicable city and cordinan I authorize representatives of this city or countenter the Date t is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrel sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 11-- �' Date L; rL z CY lending agency for the performance of the work for which this permit is issued (Section 3097. Civil Code). Lender's Address laws resting to building construction. ed pr p rty for inspection purposes. Owner's or Authorized Agent's Name kt I AC7IDN DATE BY 01 ARATION OF COMPLIANCE WITH CODEOF FOR OFFICE USE ONLY FED PALRFGIILAIIr)NSPA'tr61GFT17I-L40Hk'b AQMD RULE-14d3. PERMIT EXPIRED ❑ 1 SUBMI'TEDASBESTOf NOT..'9CATIf1N TO• ❑ EPA ElAQMD PERMITCANCELLED PERMfTEXTENDEO ❑ ASBESTOS NORFICARONIS NOT APPLICABLE TO PROPOSED DEMCLITION SIGNATURE: PERMITFINAL - i CERTIRCATEOF OCCUPANCYISSUED