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Home My WebLink AboutP2023-0480 - Permits"ewPORr City of Newport Beach IIIIIIIIIIIII��IIIIIIIIIIIII II Plumbing Permit: P2023-0480 0 4 I 6 Community Development Department- Building Division P 2 0 2 3 0 4 8 0 Plan Check No (` 100 Civic Center Drive, Newport Beach, CA 92660 Work Class : Other O = Permit Counter Phone: (949) 718-1888 Issued Date : 10/17/2023 ca. c ,r new ortbeachov/civic f P'�, 1 �' .. p 9 � Final Date: ' Permit Status: Issued Inspection Area : 5 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: 4601 SURREY DR Legal Desc : N TR 3519 BLK LOT 72 Description: PLUMB R/R 50' GAS LINE AT REAR YARD Owner: YOUNG ROBERT R TR Address : 4601 SURREY DR CORONA DEL MAR, CA 92625 Phone: Applicant: CECILIAGUTIERREZ Address : Phone : (877) 600-0123 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 (6000 indicates minimum lot area) PROCESSED BY: SPECIAL CONDITIONS: Contractor : NEXGEN A/C INC Address: 5472 EAST LA PALMA AVENUE ANAHEIM, CA 92807 Phone : (657) 208-1987 Con State Lie: 1011173 Lie Expire : 07/31/2025 Bus Lie: BT30055503 Bus Lie Expire:06130/2024 Workers' Compensation Insurance Carrier : AMERISURE MUTUAL INSURANCE COMPANY Policy No: 21207550L1. W. C. Expire: 1011/202U Fire Hazard Zone : NO Occupancy Groups: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that t am exempt from the ContractorsState License Law for the reasons) indicated below by the checkmarkjs) I have placed next to the applicable item(s) 3ectien 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 To 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 'rOfesslons 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 of more than five hundred dollars ($500). I, as owner of the property. or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not Intended or offered for sale (Section 7044, justness 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 properly, provided that the nprovements are not intended or offered for sale. It, 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 nproved for the purpose of sale). 1 I, as owner of the properly, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply 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 I am exempt from licensors under the Contractors' State License Law for the following reason: _..... .... ...... ....___ :y 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, oil 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:/fwww.leginfo.ca.gov/calaw.html. ;ignalure of Property Owner or Authorized Agent __.� �.. Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I ant licensed under provisions of Chapter 9 (commencing with Section 70 ) f Division 3 of the Business and Profess' ns Mod iz ense is in full force no effect. License Class License No Dale Contractor Signature �/S-AA Q� VORKERS' COMPENSATION DECLARATION !ARRWG: 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 (1100,000), 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: I I have and will maintan a certificate of consent to self -insure for workers' compensation. Issued by the Director Di Industrial Relations as provided for by Section 3700 or the Labor Code, for th orfomtance of the work for which this permit is issued. Policy No. Phave and will maintain workers' compensation insurance, as required by Section 3700 of the Libor Coda, for the performance of the work for which this permit is Issued. My workers' compensatiol Isurance carrier '.Enter1J,1; 7,dd/,p; nu-yM(a&,-fo Policy Number L 2 r 1 Z p2 D�- v2 Expiration Date lame of Agent Phone H certify that, in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and. agre If I should become subject to the workers co pensatwn provisions of Section 3700 of the Labor Code, I shall forthwith comply wish those provisions. �) / carafe of Applicant /�:% ... .. ..._.. Date—o nonrinu Deno _ rnu dra7rrvnnl I eunn,r '�_r�.,ry hereby affirm cider panalry of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name _ Lender's Address v my signature i iow, I certify to each of the fallowiny: I am the piooerty under or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. f agree to comply with all applicable city and county ordinances and state laws relating to building construction. € authorize n, ri-Tntatives of this city or county t nI thrabove iden tiled raperty for inspection purposes. // ,Ig InlUre of Property 0-mer or Authorzed Agent /n/,�//lryA _� Print Property Owner's or Authorized Agents Name 1 0�,; �,qc (9a�r fl-2 Date 7'17N DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY I PEGLILATIONS PART bI OF TITLE 40 AND AQMD RLILE NOTIFICATION TO PFRM1 EXDFNI+ED LIAQMD PCRMIT FINAL ❑ASfOE5105N0 1I1 15 NOT APPLICABLE TO CERT(RCAiE OF �'3 r�am,, II Y!'�'1� PROP05ED DEMOLITION OCCUPANCY IS51 SIGNATURE: