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HomeMy WebLinkAboutP2018-0348 - Permits- .;Ity of Newport Beach - Building Division IIII II IIIIIIII IIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 P BII IIII�IIIIIIIIII Permit Counter Phone (949)644-3288 ci 0 '�ZfY844 � Job Address: 101 VIA UNDINE Bldg: 1 Floor: Suite: Description of Work: PLUMIREPLACE GAS LINE TO HOUSE Inspector Area: 1 Code Edit 2016 Legal Description: N TR 907 LOT 252 Owner: MOORE REX Address: 101 VL4ytN N NEVVPORT BEACH C 92660 Phone: 9¢5-933-1558 Issued Dafe:10/12/2018 Contractor: DYMEK'S FREEDOM PLUMBING INC Address: P O BOX 696 PLACENTIA CA Phone: Con State Lic:764483 Lic Expire: 12/31/2019 Bus Lic: BT30047366 Lic Exp Date: 05/2812019 PLUMBING Permit: P2018-0348 Project No: Inspection Requests Phone (949)644-3255 • Worker's Compensation Insurance - Carrier: INS CO OF THE WEST •° ° Policy No:WSD5038260 Expire: 11/1812018 o• ° e • • • •. 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. • • • o . • . 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: 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: 3 $3.00 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: $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: $45.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $45.00 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. • • • o . • . 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 L) all of or L) 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 ffIy 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). I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature pelow J 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 Iegall 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 e Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. ',SidrMilre of Prpht ftf Qwner or Authorized Agent Date "" LICENSED CONTRACTOR'S DECLARATION yyy I ItelgUy affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business andPro'�� s de, a my license is in full force andd effect. . ` ,, // Lfcente,class * '', License No Date O /© Z Contractor Signature / �,�.r� DECLARATION 'AILURE ZOSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED`THOUSAND DOLLARS ($700,000), IN ADDITION TO THE )MPENSAI JON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ffirm under penalty of perjury one of the following declarations: .ilf • ... and wmaintain 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 IN ce of the %ygrk for which this permit is issued. Policy No. and wiN msintain 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' compensatior carrier and policy number are: is of Agent certify that, in the performance of the if I should become subject toAhe wo of Policy Number Date 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 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. IECLARATION REG RDING"CO STRUaION LENDING AGENCY / hereby affirm under penalty of p rjury that there is'a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address y my signature below, I certify to each of the following: f� 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 corn . I agree to comply with all applicable city and county ordin es an at a77 ws relating to building construction. 1 authorize representatives of this city or cou ty to enter b v -ide Ified pe y for inspection purposes. IlSignature of Prop"_Owner or Authorized Agent Print Property Owner's or Authorized Agent's Narr>0*_1'1Z1 Dat -`II ACT70N DATE BY DECLARATION OF COM PLIANCE M TH CODE OF FEDERAL REGULA TIONS PART 61 OFTITLE40AND AQMD RULE 1403. 0 ISUBM/TTEDASBESTOSN071FICATIONTO: EPA ❑ AQMD ASHESTOSPERMITFINAL PROPOSED DEMNOLITO T70NfS NOT APPLtCABLE TO N. SIGNATURE: FOR OFRCE USE ONLY _ PERMIT EXPIRED PERMITCANCELLED PERMITEXTENDED /O- 3— / S _ CERPRCATEOF QCCUPANCYISSUED