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Home My WebLink AboutP2021-0123 - PermitsCity of Newport Beach -Building Division 1pliIII 111111111111111111111101p111lIIllllp111111 r� 9 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 1 2 3 rw y�E. Permit Counter Phone (949)644-3288 Job Address: 1323 SANTIAGO DR Bldg: 1 Floor: Suite: Description of Work: PLUMB/REPLACE (E) GAS LINE TO POOL EQUIPMENT Inspector Area: 3 Code Edit 2019 Legal Description: N TR 3851 LOT 49 Owner: Address: Phone: Issued t Processed DR :H. CA 92660 Contractor: J M I AND ASSOCIATES INC Address: 2046 MEYER PLACE COSTA MESA CA 92627 Phone: 714-350-9527 Con State Lic:951957 Lic Expire: 09/30/2022 Bus Lic: BT30069739 Lic Exp Date: 11/30/2021 PLUMBING Permit: P2021-0123 Project No : 0477-2020 Inspection Requests Phone (949)644-3255 INSRECTOR Worker's Compensation Insurance - Carrier : EXEMPT Policy No: Expire : 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.uu 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: $37.00 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: $44.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $44.00 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 forthe reason(s) indicated below by the checkmark(s) I have placed next to the applicable itena(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, prior to its issuance, also requires the applicantfor 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). ❑ I, 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, 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 exempt from licensure under the Contractors' State License Law for the following reason: By 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', sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. Signature of Profe7y Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hPreh,, affirm. under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions ode, and my license is in full force and Effect. Licenso Class License No Date Contractor Signature � Q 1 11[(:!0 1`P tc4C 11VORifERS' COMPENSATION DECLARATION NA6NIN(.: FAILURE TO SdCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE C! )S1 OF COMPENSA'i IuN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herehv affirm wider pallalty of perjury one of the following declarations: t.a+e 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 �*ksnce of the work for which this permit is issued. Policy No. and wid 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: Policy Number Expiration Date of Agent 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 if I should become subject to the orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /� lature of Aoolicant XL.-. /1 9--�'� t�pCe Date�n LI :7, % I sreby affirm under llenalty 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). lder's Name Lender's Address 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 county ordinances and state laws relating to building construction. 1 I authorize representatives of this city or county to ant the /a/t,ove-identified property for inspection purposes. nature of Property Owner or Authorized Agent Property Owner's or Authorized Agent's Name. ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ASBESTOS NOTIFICATION IS NOT APPLICABLE TO P OPOSED DEMOLITION. n PERMITFWAL CERTIR'CATE OF OCCUPAINCYISSUED SIGf TURF ( % :.