HomeMy WebLinkAboutP2023-0568 - PermitsatiWoRr City of Newport Beach
o� 19 Community Development Department -Building Division
> Y 1 o0 civic center Drive, Newport Beach, CA 92660
U > i Permit Counter Phone: (949) 718-1888
QCq��O RN�P newportbeachca.gov/civic
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Plumbing Permit
Plan Check No :
Work Class : Other
Issued Date : 12/1412023
Final Date:
Permit Status: Issued
Inspection Area : 6
P2023-0568
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
: 15 BELLEVUE
Description:
PLUMB WATER HEATER REPLACE
Owner:
KAI-YIN CHUNG
BELLEVUE NEWPORT COAST, CA 92657
Address :
15
Phone:
(310)567-8062
Applicant:
CECILIA GUTIERREZ
26111 YNEZ RD, C3 TEMECULA. CA 92591
Address :
Phone:
(877)600-0123
owner/Builder:
Address
Phone:
Code Edition : 2022
Type of Construction :
Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 10
Flood Zone : X
Use Zone: PC - Newport Ridge
*�wPROCESSED BY:
SPECIAL CONDITIONS:
Legal Desc : N TR 14895 BLK LOT 57
Contractor : NEXGEN A/C INC
Address : 5472 EAST LA PALMA AVENUE ANAHEIM, CA 92B07 ,
Phone :
(657) 208-1987
Con State Lic:
1011173
Lic Expire :
07/3112025
Bus Lic:
BT30055503 '
Bus Lic Expire:06130/2024
Workers' Compensation Insurance
INSURANCE COMPANY
Carrier :
AMERISURE,MUTUAL
Policy No:
WC21148830402 "
W, C. Expire:
10/1/2024
Fire Hazard Zone : NO
Occupancy Groups:
ILDER
I hereby affirm under penalty of perjury that I am exempt from the Contractors': State License Law for the reasori(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 10 construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the a licanl 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 Divisi 0 the Business and
Professions Code) or that he or she is exempt from ticensure 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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all Of or portions of the work, and the structure is not intended or offered for sale (Section 7044,
po (_) Business and Professions Code: The Contractors' State License Law does not apply to on owner of property po through employees' or personal effort, builds or improves the properly, provided that the
improvements are not intended or offered for sale. If, however, the building orimprovemenl. 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).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the prcjecl (Section 7044, Business and Professions Code: The Contractors' State License Law' does not
Qapply 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 Lave).
I am Exempt from licensure under the Contractors' Stale License Law for the following reason: _ By my signature below I acknowledge that, except for my personal residence in which I must have reside__d for at feast one year priori to completion of the Improvements covered b 'this Permit, I
soot a structure that I have boilt as. an ownertbuilder if it has not been constructed in its. Entirety by licensed contractors.. I understand that a copy of tho appiicablE dew, Section 70Mt of the Business Signature o Code, is available upon request when this application is submitted or at the fallowing Web site:htt /,'www,l y p i cannot legally
Signature of Property Owner Or Authorized Agent _ _ � P: eginfo.Ca.gov/calavefitml. ass and
_ICENSED CONTRACTOR'S DECLA'.RATIDN �`� ------ Date
hereby t. LI under penally of perjury that i am licensed under provisions Of Chapter g (commencing with Sec 700 ) of tvision 3 of t usiness and Profes ' s`Cp .'and m r iceose is In full force
and effect. License CJass License No
V^P,K>=RS' COMPENSATION DECLARATION
)at tCi actor Signature _
fARNING. FAILUR TO aECJRE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS {$t SR,SDO), IN AODRION TO THE
JST CF COMPENS'.T ON, hkMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herby affirm unr'.er penalty of perjury one of the following declarations,
Deve and gall maintain a certificate Of consent to self -insure for workers' compensation, issued by the Director O€ Industrial Relations as Provided for by Section 3700 of the Labor Code, for !h
�earf('d.Ygof the work for which this permit is issued. Policy No..
an
wl. me n aln 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 end policy number are:
cf Agent __
Policy Number
Date
-It certify that, in the performance of the work for which this permd Is Issued, shall not employ an Hrione #
Wet, if shaulti.�eDeme sub t to the rkers COmPanS Ion provisions of Section 3700 of titile Labor Code. I shall forthwith comply *fiat Hose provisionsbecome subject to e workers' compensation laws of California, and ogre
ignature I lippl cant ECLARATION REGARD G ONST UCTIONLENDINDater/ C��ji�
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of Lhe work for which this permit is issued (Section 309T, Civil Code).
Date —
Finder's Name
y my signature below, I certify to each of the tolowing: Lender's Address
i an, 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 10 comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of thi city or county to ter the Bove-ide ified property for inspection purposes, n gnalure of Prorerty / P P P ,
DATE tlV f DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OFTITL 40 AND AQMD RULE R OFFICE USE ONLY
PERMIT
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PERMIT FINAL
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W L_I ASEESTOS NOT] FICATtON IS NOT APPLICABLE TO
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