HomeMy WebLinkAboutP2018-0307 - Permits,� City of Newport Beach - Building Division *P2018-0307* PLUMBING Permit: P2018-0307
100 Civic Center Drive, Newport Beach, CA 92660 Project No:
�, # Permit Counter Phone (949)644-3288
9v 41
�•s �hL�'R� Inspection Requests Phone (949)644-3255
Job Address: 11 HUNTINGTON CT Bldg:
1 Floor: Suite:
Description of Work: PLUM WATER HEATER C/O
FEES
04
Bathroom Fixtures
Kitchen Fixtures
Inspector Area: 8 Code Edit 2016
Misc.
• •
Legal Description: N TR 11450 LOT 1
Toilet:
0
$0.00
g • • ° • o
Owner: NORTHRUP DONALD
Contractor:
PAYLESS WATER HEATERS
Worker's Compensation Insurance -
• °
Roof Drain: 0
Address: 11 HUNTINGTON CT
Address:
27919 SMYTH DR
Carrier: EMPLOYEE SVC GROUP
0
• • °
NEWPORT BEACH, CA 92660
0
VALENCIA CA 91355
Policy No:C65197844•
• •
• °
Phone:
Phone:
661-775-2944
Expire 08/01/2019
Urinal
•• °
$0.00
Con State Lic:836216
0
•+mss
• ° • ° °
•••••m
IssuedDate:09/11/2018
Lic Expire:
08/31/2020
$0.00
Bath Tub:
Bus Lic:
BT30041725
Vegetable Sink:
0
mo•000
Processed By:
Lic Exp Date:
12/11/2018
P -Trap: 0
$0.00
o m n
• °
$0.00
Shower Stall:
0
$0.00
0o e
o m m
00
mm••om
o n
mmmm
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.
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:
1
$15.00
Grease Interceptor:0
$0.00
Bath Tub:
0
$0.00
Vegetable Sink:
0
$0.00
Gas up to 4 outlets:
0
$0.00
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:O
$0.00
Lndrylrrap:
0
$0.00
Backflow over 2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
$33.00
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: $48.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance: $48.00
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
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).
❑ I, 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,purppse 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 o wnev sPproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
•❑ I qn exemptilDfn licensure under the Contractors' State License Law for the following reason:
Bgmysignaturedselowd 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 structhedatl. have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Pr%essions Cqde, is available upon request when this application is submitted or at the following Web site:hltp://www.leginfo.ca.gov/calaw.htm].
'Signature of Property Owner or Authorized Agent Date
• ..... • LICENSED CONTRACTOR'S DECLARATION
16reey affirm under penn�alty of perjury that I am licensed under provisions of Chapter 9 (commencing th Sectio 70 0) of Division 3 of the Business a Professions Code, and my license is in full force
..OVO effect.
jgePga Class • • • • L" 3z License No � ZF2 Date l Contractor Signatur -�1 L-r/�� ( A/
11LOBKERS' COMPENSATION DECLARATION
NINGg FAILU lg II%°f.�IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN E
T OF COMPEN ATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND AT
reaffirm uades penalty of perjury one of the following declarations:
I have and All Maintain a certificate of consent to self -insure for workers' compensation,
91 -mance of the work for which this permit is issued. Policy No
CRIMINAL PENALTIES AND CIVIL FINES UP`TO (NE HITNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO
issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
ve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this ermit is issued. My workers' compereatior
Ice carrier an oli y ryt�ber are: % /nf �/ �� % 9
Policy Number Gm l %" Expiration Date / /% 7 .
of Agent Phone #
I certify that, in t mance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject tot €workers' compensation laws of California, and
t, if I should become s b) t to the workers' compens ' visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi s. �J
nature of Applicant Date /l
CLARATION REG CO STRUCTION LENDING AGENCY
:reby affirm unde 6 y of perjury that there is a construction len Ing agency for the performance of the work for which this permit is issued ( ection 3097, Civil Code).
lder's Name Lender's Address
my signature belo I certify to each of the following:
I am the propertowner or authorized to act on the property owner's behalf.
I have read this application and the information I Pve provided is correct.
I agree to comply with all applicable city and Co ty ordinances and state laws relating to building construction.
I authorize representatives of this ci r count to the above -Iden ' o erty for inspection purposes.
nature of Property Owner or Authorize Print Property Owner's or Authorized Agent's Date
ACTION
DATE
RYLARATION
OF COMPLIANCE MTH CODE OF
FOR OFFICE USE NtY
M DERALREGULATIONSPART61OFTITLE40AMD
AQM0 RUL€M3.
PERM/TEXPIRED
0 I SUSMfTTEDASBESTOS NO7IFICATION TOr
0 EPA
0 AQMD
PERMITCA.NCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIRCATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
/
CERTIFICATEOF
QCCUPANCYISSUED
SIGNATURE: