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Home My WebLink AboutP2023-0155 - Permits��EWPORT City of Newport Beach p Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 u NiD 2 Permit Counter Phone: (949) 644-3288 C9L�OA�`P Inspection Requests Phone: (949) 644-3255 neWPDrtbeachce.gov/inspections 1111111111111111111111111111111111111111111111111111 jj Plumbing Permit : P2023-0155 Plan Check No : PC2022-2622 Work Class : Other Issued Date : 04/24/2023 Inspection Area :4 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: 5 CYPRESS POINT LN Description: PLUM GAS LINE TO BBQ Legal Desc : N TR 7223 BILK LOT 15 Owner: JAMES MARKHAM Address : 5 CYPRESS POINT LN NEWPORT BEACH, CA 92660 Phone: Applicant: MADISON J L CO Address : 24682 DEL PRADO #230 DANA POINT, CA 92629 Phone : (949) 212-6922 Owner/Builder : Address Phone: Contractor : MADISON J L CO Address : 24682 DEL PRADO #230 DANA POINT, CA 92629 Phone: (949)212-6922 Con State Lic : 672668 Lid Expire: 06/30/2023 Bus Lid : BT30080173 Bus Lid Expire:12/31/2023 Workers' Compensation Insurance Carrier: OHIO SECURITY INSURANCE COMPANY Policy No: XWS60277669 W. C. Expire: 101112023 Code Edition : 2022 Fire Hazard Zone : NO Type of Construction : Occupancy Groups : "t Building Setbacks : Front: 10, Side: 5, Side: 5 - Flood Zone : X Use Zone : PC - Big Canyon yy -J PROCESSED BY SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the ContractorsState License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(a) 3ect'ion 7031.5, Business and Professions Code: Any city or counly that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires file applicant for io 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 rofessions Code) or that he or she is exempt from licensure andthe 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). 7 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, usiness 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 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 ❑proved for the purpose of sale). 3 1, 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 pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuantto the Contractors' State License Law). 3 1 am exempt from licensure 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 legail all a structure that I have builtas an owner -builder if it has not boon 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 A'eb site:http:Rwww.leginfo.ca.gov/calaw.html, signature of Progeny Owner or Authorized Agent _ Data ]CENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under previsions of Chapter 9 (Commencing with Section 00 Dfv'si n 3 of Ijjyypp Business and Pr, ssi s CodeTny cense is II force no effect. License Class License No Date 1% lKneactor Signatur 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 ($100,009 %IN ADDITION TO THE GIST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37" OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES. hereby affirm under penalty of perjury one of the following declarations: have and 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 rmance 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: is of Agent _ Certify that., in the pI if I should become lature of Applicant _ Policy Number Date gee the work i which this permit is issued., I shall not employ any person in any manner so as to become subject to the workers' compensation la rs of Califomra, and afire tote he C ensation provi' s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. TRU ENDI. AGENCY hereby affirm under penalty of perjury theNbAilre is a construction lending agency for the performance of the work for which this permit is issued (Section 309T, Civ I Cad ender's Name Lender's Address y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners Too hlf. I have read this application and the Information I have mvided is coI agree to comply with all applicable city and county o nances andtlaws relating to building construction. { authorize representatives of this city or county/o en r the above -id led property grwi spestlon purposes. r DATE BY --tPECLARATIQN QF COMPLIANKLAVITH CODE OF FEDERAL FOR OFFICE USE ONLY REC ULATION ART 61 OF TITLE 40 AND AQI RULE PERMIT CANCELLED UEPA PERMIT EXTENDED— AQMD PERMITFINAL _ n., ... .... ELF ASHES 105 NOTIFICATION I5' NOT APPLICABLE TO CERTiFICATEOF OCCUPANCYISSUEO 1. ��, PROPOSED DEMOLITION j SIGNATURE; L-J /A 17ate`II 2-