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Home My WebLink AboutP2018-0237 - PermitsCity of Newport Beach - Building Division *P2018-0237* PLUMBING Permit: P2018-0237 k & 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0532-2016 A Permit Counter Phone (949)644-3288 Inspection Requests Phoon 49)644-3255 Job Address: 1973 PORT PROVENCE PL Bldg: 1 Floor: Suite: Description of Work: PLUM - GAS LINE TO BBQ LP Inspector Area: 4 Code Edit 2016 Legal Description: N TR 6624 LOT 53 Owner: RANNALA ERIK & KRISTEN Contractor: RJ TANNER CONSTRUCTION Worker's Compensation Insurance - Address: 1973 PORT PROVENCE PL Address: 893 OAK STREET Carrier: CALIF INS COMPANY .... NEWPORT BEACH CA 92660 COSTA MESA CA 92627 Policy No:4688992401 Phone: 415-309-5109 Phone: 949-235-4856 Expire 0610112019 Con State Lic:744104 mE Issued Date:07/16/2018 Lic Expire: 1213112019 m Bus Lic: BT98043220 e o Processedo°0000 y: is Exp ate: 06/30/2019 ° o . o Damm O° ° n am m o 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. moeoa 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 GarbageDisp: 0 $0.00 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 3100` ®mm 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 $6.00 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: $0.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $9.00 Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 Additional Fee : $0.00 TOTAL: $15.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $15.00 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, 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 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). ❑ 1, as owner of the property, or. my employees with wages as their sole compensation, will do (_) 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). 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 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 legalh 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://v w .leginfo.ca.gov/calaw.html. Signature of Pr9Perjy Owner or Authorized Agent Date ',,,,' LICENSED CONTRACTOR'S DECLARATION I hereby affirm undgr.penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profen ode, and my license is in full force 'Meffect.. �Icenyse Class" License No Date Contractor Signature pVOU''ERS' COMPENSATION DECLARATION WQgRNIIfp: FAILUR@706R0'JRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED OUSAND DOLLARS 15'100,0001, IN ADDITION TO THE BAST OFCOMPENSATION, eAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Phere'try affirm under penalty of perjury one of the following declarations: cafe 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 th, pgrjQrmanceyf-the'work for which this permit is issued. Policy No. and wil►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 rte of Agent Phone # 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 I, if I should become subject to th orkers' ompensation pro 'sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. � _ nature of Applicant �- Date CLARATION REGARDING CONS-rRUC70V L&NqNG AGENCY lreby affirm under penalty of perjury tha there is a onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civi ode). ider'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 o nces and state laws relating to building construction. I authorize representatives of this city or count o bove-identifi party for inspection purposes. % . �l nature of Property Owner or Authorized Age Print Property Owner's or Authorized Agent's Name' 2 /f/i'✓Jf.'=p t3 e ACTLON DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 61 OFTIILE40AND AQMDRULE 1403. P€RWI-EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANC€LLED PERWITEXTENDED ❑ ASBESTOS N017FICA1I0N/S NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITFINtt 1 CERTIFLCATEOF OCCUPANCYISSUED SIGNATURE: