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Home My WebLink AboutP2021-0521 - PermitsCity of Oewport Beach - Building Division 111p111111111p11111p111111111111111111111111111111 4 100 Civic C nter Drive, Newport Beach, CA 92660 P 2 0 2 1 0 5 2 1 Permit Ccu I ter Phone (949)644-3288 ('rgYOYY�= Job Address: 2419 SAW Description of Work: PLUM Inspector Area: 3 Legal Description: NEWPOR Owner: VANDERHOOK Address: 2419 SANTIAGt NEWPORT BEF Phone: Issued Date:11/04/2021 Processed By: Bathroom Fixtures Toilet: 0 Bidet 0 Urinal 0 Bath Tub: 0 Shower Stall: 0 Wash Basin: 0 Hydro -Mass Tub:0 Floor Sink: 0 Floor Drain: 0 60 DR Bldg: 1 Floor: Suite: GAS LINE TO BBQ PLUMBING Permit: P2021-0521 Project No : 1053-2021 Inspection Requests Phone (949)644-3255 If aPC�lica��e' 0% Vet. Code Edit OK 1� HEIGHTS LO9 78.7:FFT 2gLY17 FT / Q $�% LA ,tract DR US LL �e'�teAnress 10 SAR€NIMINGO �.�.� to w�Carrier: LIBERTY MUTUAL C 92660 ' IRVINE CA 92612 Policy No:XWS60931071 Policy -I--- -' 714-235-8644 Expire : 12/21/2021 on State LIc:919876 - Lic Expire OW2872022 -Bus,Llc BT300676� ,,,, r ge'D Lic Exp Date 11/301202eP1 � V R JP+ G FEES Kitchce Misc. sc. Kit hen ..... 0 $0.00 Water Piping 0 $0.00 Roof ke1w. Other 0 St $0.00 0.0,0 Garbag Dis $000 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 .00' Bar Sink 0 $rU6 ~ "Water He j 0 $0.00 Grease Interceptor, .00 Vegetebl Sin $0.0 O� e�QB(S Outlets: 1 $8.00 P-Tr 0 S oAll, +a M r $0.00 Ice Make- 0 $O.O w as over 4 outlets: 0 $0. ewer �� ion: $0.00 Dishwash 0 $0.00 Backflow, up to 2 $0.00 Sewer: 0 Plan Check: $0.00 Lndry[Trap 0 $0.00 Be ver 2": 0 $0.00 ewer ir:0 $0.00 Issuance: $38.00 Regulator: 1v te$ Hose Bibb: .00 er Abandon: 0 $0.00 Supplemental Fee: $0.00 Lawn Sprin rtv0 $0.00 Drin ' n ain, . 0 Additional Fee : $0.00 $46.00 - Plan Check Fee : $0.00 Fee Due at Permit Issuance : $46.00 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 reasons) indicated below by the checkmark(s) I have placed next to the applicable items) (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 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 ttie Business anc 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 U 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 Prof e: The Contra apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor a ontractors' State License ❑ I 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 or at least one year prior ¢,Don of the improvements sell a structure that I have built as an owner -builder if it has not been cons entirety by licensed contractors. Itra, at a copy of th� pDJ'I� Professions Code, is available upon request when this a an or 11EYollowing Web sit�e�://�.leginfo.ca.gov/cala Signature of Property Owner or Authorized A ll�� l� LICENS ONTRACTOR'S DECLAR IO State License Law does not this permit, I cannot leg )44 of the Business and I hereby affirm under penalty of perjy that I Emil eased under of Chapter 9 (comme g tla.. 7000) of Division 3 of the Business a sfeS ions Co and m license is in full force and effect.I � ° Qfi1. License Class License No :`"�* ' Date � ii, -1..tQ "Cdntractor Signatur WORKERS' COMPENSATION DE LAR " NARNING: FAILURE TO SECURE WORKERS' CO ENS ION COVE E IS UNLAWFUL AND-SHALt�SUBJECT AN EMPLaVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOL RS IS700,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVI DFO NSECTIO 060F",ELADOROODE, 10+REST, AND ATTORNEY'S FEES hereby affirm under penalty of perjury d of t folio decl 31111ions ❑ I have and will maintain a certificate f co n to self -insure for workers compensation, issued by the Director of Industrial Relations as provided for by Section 37 of the Labor Code, for thl oe ormance of the work for which this per it is issued. Cy No - ave and will maintain workers' comp nsati `i in ura as , quirod by Section 3700 of the Labor Code, for the performance of the work for which ttts,pgrr�fl[�s issue My workers' compensation su nce carrier and policy number are: r ii VBs� y� a roar � _ umber � �� P9_._L* �!x ir�erp$ IS of Agent i certify that, in the performance of the woo w tofwhich is permit is issued. I shall if I should become subject to the worker cc an on i Vection Iature of Applicant �I employ any person in an,liii so as o �Q �s t t'a`ihe I of the Labor Code, I shall forthwith CLA V+Rti those provisions. compensation lays of California, and I hereby affirm under penalty-ai'perjury that the a Is a construction l %66 y for the performance of the work for whi Trill is issued ( ecq�l f,® �i +f ode). Lender's Name Lender's Address gT5 By my signature below, I certify to each of the f owing: I am the property owner or authorized to act i. n hF ��¢o8erty owner' I have read this application and the informati n o ed is correct. I agree to comply with all applicable city and unty ordinance and a a Ing to to ' ruction. I authorize representatives of this city or cou N ant a--' of or inspection purposes. Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Name Date ACTION DATE R. _ DECLARATION OFCOMPLIANCE AgTHCODEOF FEE:7: ,4L RECULATIONS PA r?' 64 7F TITLE 40 AND 4QMI I RULE 14113. ❑ I SUBMGTEDASDESTOS iK1T7�ICATION TO: [3 EPA [IAQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PAOFOSCD DE,1,7OUTION. SIGN4TURc FOR OFFICE USE ONLY PERMIT EXPIRED �'"� - PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIRCATEOF OCCUPANCYISSUED