HomeMy WebLinkAboutP2019-0209 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIUI�IIIIIIIIIIIIIIII PLUMBING Permit: P2019-0209
o 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 9 2 0 9 Project No: 0741-2017
Permit Counter Phone (949)644-3288 )
cucrve7x"a* Inspection Requests Phone (949)644-3255
Job Address: 2024 NAUTILUS LN Bldg: 1 Floor: Suite:
Description of Work: PLUM GASLINE TO FIRE PITS (2) AND BBQ
Inspector Area: 3 Code Edit 2016
Legal Description: N TR 3763 LOT 75
Owner: HOLIDAY ADAM & JULIE
Contractor: OWNER/BLDR
Address: 2024 NAUTILUS
Address: HOLIDAY ADAM
NEWPORT BEACH, CA 92660
Phone:
Phone:
Con State Lic:O/B
Issued Date:07/02/2019
Lie Expire:
C,
Bus Lie:
Processed By: -vhf yl / \
Lie Exp Date:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday- Fdday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m..
h.
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0 0 o moeoo
FEES
Worker's Compensation
Insurance -
Carrier :
°°°°`
Bathroom Fixtures
Policy No:
Kitchen Fixtures
Expire
Misc.
0
coo a oemmoc
Other
0
00
0
0
$0.00
ee
einem
0
°
0
$0.00
0 0
000m o m
00
0
$0.00
0o m
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday- Fdday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m..
0 0 o moeoo
FEES
°°°°`
Bathroom Fixtures
Kitchen Fixtures
Misc.
Misc.
Other
0
Toilet:
0
$0.00
Kitchen Sink:
0
$0.00
Water Piping:
0
$0.00
Roof Drain: 0
$0.00
Bidet
0
$0.00
GarbageDisp:
0
$0.00
Water Softener:
0
$0.00
Grease Trap: 0
$0.00
Kok
Urinal
0
$0.00
Bar Sink:
0
$0.00
Water Heater:
0
$0.00
Greaselnterceptor: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: -
$35.00
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:
$42.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance : $42.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday- Fdday 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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, e
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
iTproved for the purpose of sale).
IP -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 Lay for the following reason:
By my signature below I acknowledge that, except for my personal rest n In hic have resided for at least one year prior to completion of the improvements covered b this permit, I cannot legally
sell a structure that I have built as an owner -build ' if it has not I on uc its Irety by licensed contractors. I understand that a copy of the applicable law, Sectio 044 of the Business and
Professions Code, is available upon request wh this applicat' Ilowing Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Dat
..er
LICENSED CON*ACTOR'S E LAR
I hereby affirmunder penalty of perjury that I afn licensed under provisions of C apter 9 (commencing with Section 7000) of Division 3 of the Business and Professionsode, and my license is in full force
and effect. ""
t itI511 ;Class • • • • License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
4ARAIf16PFAILURE TASECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSAirM,,DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
l eaiebyaffirm uruieapenalty of perjury one of the following declarations:
aI pave and yAll rptotain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Cade, for thl
performance of the -work for which this permit is issued. Policy No.
JlJws and will rAnaintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compens
Isdranc$ carrielDW4 P41icy number are:
3rl0er,. ' Policy Number Expiration Date
eraeOfAgent •' ' Phone#
31 certify that, in the erformance of t ork fo hi pthiit is issued, I shall not employ any person in any manner so as to become subject to th orkers' compensation laws of California, and;
tat, if I should beco subject to the o ers' o isions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio .
ignature of Applica Date
DECLARATION RE ARDINGCONSTRKU1 I IN GENCY
hereby affirm unde penalty of perjury that there is a c truction lending agency for the performance of the work for which this permit is issued ( action 3097, Civil Code).
enders Name Lender's Address
y my signature below, I certify to each. the
I am the property owner or authorizedd to actct on on the property owner's behalf.
1 have read this application and the information I ha a provided is correct.
I agree to comply with all applicable city and coun Ord
i anc an ate laws relating to building construction. /
I authorize representatives of this city or county t ant th a ified property for inspection purposes. /
innature of PrnnerIv Owner or Authorized ADent Print Prooertv Owner's or Authorized ADent's Nam to
ACTLON DATE • BY
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FEDERAL REGULATIONS PART 61 OF TIRE40AND
AQMD RULE 1403.
PERMIT €XPFRED -
I SUBMTTEDASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS N071FICA170NIS NOT APPLICABLE TO
PROPOSEODEMOLITION.
PERMITFINAL j
CERTIFICATE OF -
SIGNATURE.
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