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HomeMy WebLinkAboutXR2023-0029 - PermitsCity of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIII ��gWPORT i Q Community Development Department- Building Division X R 2 0 2 3 n 100 Civic Center Drive, Newport Beach, CA 92660 dq Permit Counter Phone: (949) 644-3286 Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Combination Type - SFP PLUM Work Class - Alteration a PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR L ��.pp, VALIt},kvsPECTC0I NO CONSTRUCTION RELATED NOISE ON SATURDAY_ SUNHI�*<DEI` Job Address: 4 WHITESANDS DR Description: SFR - PEX RE -PIPE . 22 Owner: Address Phone: Applicant: Address Phone Owner/Bw Address Phone: Permit : XR2023-0029 n Check No: d Date Inspe ion Area : 6 BUT NO ATER THAN 3 YEAR TY AREAS AND NO WORK ON .! O'O" O _ JL al Desd&N TR 14QR BLK LOT 20 }� Contractor :"'PIPELINER2ESTORATIONPLUMB] f1l3')Ire itect Address: 29291 KENSI,NGSTON DR /'�ddress N E W PORT COAST, : 92657 De LAGUNA N I GU E L, CA 92677 APhone : (714) 860-4250 �Q�a1Phone `''-- Con State Lie : 96 4 ,+(% ��a State tc : g. Lie Expire : 08 31/2023 PIPELI RESTOR ION PLUMBING Bus Lie:: BT300741 QQQ0 ®` �Ot� ng-' 29 KEN ON DW Bus Lie Expire : 01/31/ �O A as L UN EL, CA 926 Q (7. 860 250 Workers' Compensation rance ��� V a: � - Carrier: SENECA INS CO INC eT` Policy No: WC1385951 Designer ki}y. W. C. EXpift- 1312023 Address VY' r'- ` M'Phone QINGBIN MENG 4 WHITESANDS DR Code Edition : Type of Construction Occupancy Groups: Bldg Height: ORIGINAL ISSUANCE DATE (AND HOLIDAYS IN ALL AREAS FORM 0100 IM f Faille Spyt ers : Construction Valuation : $8,950.00 (may it and Zone - NO Added/New/TI sq. ft. Bldg : 0 v \\ Units : 1 Alteration sq.Bldg "-No off Stori Added/New sq.. ft. Garage : 0 TOTAL sq. ft. : 0 Building Setbacks: Front:10,- % e: Sid�Rear:10/ Flood Zone : X Use Zone: PC - Newport e Ode, PROCESSED BY: SPECIAL CONDITIONS: I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law f Secton 7031:5, Business and Professions CodeAny city or county that requires a permit to Xet"ot,17 Td permit to Fite a signed statement that he or she is licensed pursuant to the provisions of th'rofassions Code) or that no or she is exempt from licensureand the basis for the alleged a of more than five hundred dollars ($500). 3 I, as owner of the property, or my employees with wages as their sole compereati , will do TIR iusiness And Professions Code. The Contractors' State License Law does not app an ow f AT nprovements are not intended or offered for sale If, however, the building or I enter iLt old wit nproved for the purpose of sale)\s```PP oo 1, as owner of the property, am exclusively contracting with licensed C ractors to constr IS ly to an owner of property who builds or improvesthereon, and who niracls for the pr ec with a I am exempt from licensure under the Contractors` State Licen aw for the ollowing reason: --N ly my signature below I acknowledge that, except for my person residence which must havgr(95I ell a structure that 1 have built as an owner,t citr.• d it has n qon oonst clad i I t'irety y Bitter `rotessions Code, is available upon request when this app aSo n is su Itted �'th a Web signature of Property Owner or Authorized Agent the reasons) indict D+ m by the checkmark(s) I have placed next to the applicable ites) alter, Improve, lish, or repair any -structure, prior to its issuance, also requires the applicant for ;tors' State LiA Law (Ch ter 9 (commencing with Section 7000)of Division of the Business and Any violat \of Section 70 ,5 by any applicant for a permit subjects the applicant to a civil penalty of J' q Of pO ttions of. a work, and the str4ture is not intended or offered for sale (Section 7044, 3 O, throw employees' or personatFgffort,'builds or improves the property, provided that the o" year O. ompletion, tho Owner-$uild4 01 have the burden of proving that it was not built or N`�4W, ohn; lion 7044, Business and Professions C©l : The Contractors' State License Law does not I !i ad Contractor pursuant to the Contractors' S License Law), at least one year prior to Cr ttractors, i understand that ICENSED CONTRACTORS DECLARA110 hereby affirm under penalty of penury that I am .used rovislrgn c of Chapter 9 Icon iniencmq AA;hh Section 700gic f t Btu TIC effect. License Class icense Nb _ _ Da � IT; PORKERS' COMPENSATION DEC L ATd0 lcot` �a IARNINO. FAILURE TO SECURE WORKERS C [NSATION C FERASE H(O- LAAFUL AND SHALL SUBJECT AN EN PLDYER TO CRIMWAL S AN*IL FINES UP DST OFCOMPENSATION,DAMAQVS AS PR ED FOR IN CTPON 3TOS OWTnE LA9pg COOT, IN I ERCSr AND ATTORNEY S F EES hereby affirm under penalty of p ry one of Follow crlarauons. XDe NI have and will maintain erliticate cons to .it insure for workers com ssuod)kt<j Cdflndusinel tati49�T�{\ormance of the work f hich this it is' Pgiwi Flofi� pave and will ma in wo 'Comports ins ins nee as required by Section 3I70p of the Labo e, for the pedor anceaf sy� dance carrier oolicv er are: 01, to of Anent Certify that, fn' ancr if I should ABDO i to If rature of Applicant areby affirm under penalty th i rder's Name my signature below, I Certify to a fol r19- 1 am the property owner or amino :io t on the I have read this application and the I r _ a. I ha I agree to comply with all applicable el' e Itty I authorize representatives of this city or sty PERMIT EXPIRED .{�.� �'g : i.► —� +I PERMIT CANCELLED PERMIT EX7EMDEV PPRMrT EINAi Aggg57r CERTIFICATE Of PROPOSED OCCUPANCYISSU€A SIGNA4UR s covered by this permit, 1 cannot Section 7044 of the Business and my license is In full force DOLLARS ($1 WON). IN ACOntON TO THE for by Section 3700 of the Labor Code, for for which this permit is issued. My workers` tarIii6fration Date Phone # 0 issued, I shall " toy any person ar; manner p' a become subject to the workers' Compensation laws of California, and agree sons ' r Sf the Labor Code, I all to rafhy fmpPy with (hose provisions. 01 m cyice i,�e performs a of the o r which this permit Is issued (Section 3097, Civil Code). �..�.. r� ender's A ress is and state Is it g construction. Ifle Arty r I. etlon purposes. � � ��� Pon[ Property Owner's or Authorized Auent's Name ti OA d Date Yf1MPLIANfEw�jff CODEOF FFOERAL I FOR OFFICE USE. 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