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Home My WebLink AboutP2019-0206 - Permits,'.wt1„4 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIII II PLUMBING Permit: P2019-02 o 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 9 0 2 0 6 Project No : 0042-2019 Permit Counter Phone (949)644-3288 U 4! CNt�enuN`> Inspection Requests Phone (949)644-3255 -j. Job Address: 4531 CAMDEN DR Bldg: 1 Floor: Suite: P„ Description of Work: PLUM GASLINE TO FIREPLACE / b A Inspector Area: 5 Code Edit 2016 Legal Description: N TR 3357 LOT 136 Owner: WILLIAM APPLEBEE TRT OF95 Contractor: S C HOMES INC Worker's Compensation Insurance - „lip � ?� Address: 4531 CAMDEN DR Address: 3050 PULLMAN ST Carrier: STATE FUND CORONA DEL MAR, CA 92625 COSTA MESA CA 92626 Policy No:1763760 Phone: Phone: 949-723-4243 Expire:01/0712020 ..., Con State Lic:828216 Issued Date:07/01/2019 Lic Expire: 1213112019 Bus Lic: CC-/"� BT30002421 Processed By: / Lic Exp Date: 0212812020 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 $7.00 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 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $35.00 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: $42.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $42.00 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 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). ZI 1, as owner of the property, or my employees with wages as their sole compensation, will do J 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 -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). ❑ 1 am exerrlpf fFom licensure under the Contractors' State License Law for the following reason: By my signatLr.: Julow 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) sJ1 a strvctum tKat 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.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm undr.r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing th Sec ion 7000) of Division 3 of the Business an Pr ssions Code, and m nZiull force I and effect. License Class-_ _ _ License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE '10 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS t$100,0001, IN ADDITION TO THE CCS r Jr COMPENFATION; 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: ❑ 1 have and vAl. 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 thl 3,1 ionnance of ths'.wrk for which this permit is issued. Policy No. have 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' rance carrier and policy number are: Policy Number is of Agent certify that, in the perfoJ�mn �a of the work for which this if I should become sUblec�tdthe workers' compensatio. Iature of Applicant _ Date is issued, I shall not employ any person in any manner so as to become subject ions c�6Section 3700 of the Labor Code, I shall forthwith comply with those provi compensation laws of California, and I hereby affirm under penalty 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). Lender's Name Lender's Address By 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 con rdinances and stat s re', ting building construction. I authorize representatives of this city of county to ter the above -id pro a or inspection purposes. C,.., ,, , / 1 Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na & y''�' � 1 0�- /Date j ACT70M DATE BY DECLARATION OF COMPLIANCEWITN CODE OF FOR OFFICE U5E NLY FEDERAL REGULATIONS PART 61 OFTITLE40AND AQMD RULE 1403. PERMITEXPIRED ❑ I SUBMITTED ASBESTOS N071FICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS N017FICA170NIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTfFICATE OF SIGNATURE: OCCUPANCYISSUEO