HomeMy WebLinkAboutP2019-0135 - PermitsCity of Newport Beach - Building Djyis`gne m
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100 Civic Center Drive, Newport Beach, CA 92660 ® e � ,P e 1 9 0 1 3 5
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Permit Counter Phone (949)644-3288 • m • • e ° •. ° e • ® ° ® °
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Job Address: 500 LAVER WAY Bldg: 1 Floor: Suite:
Description of Work: PLUMB -WATER HEATER C/O
Inspector Area: 8 Code Edit 2016
Legal Description: N TR 6905 LOT 32
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Owner:NORD FREDERIC J
Contractor:
GREENSTAR HOME SERVICES
Address: 500 LAVER WAY
Address:
1951 N MAIN ST
NEWPORT BEACH, CA 92660
FEES
ORANGE CA 92865
Phone:
Phone:
949-885-0102
Bathroom Fixtures
Con State Lic:795556
Kitchen Fixtures
Issued Date:05/01/2019
Misc.
Lie Expire:
02/29/2020
Misc.
Other
Bus Lie:
BT30056111
Processed By: -Lie
Exp Date:
08/31/2019
PLUMBING Permit: P2019-0135
Project No:
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier : LIBERTY INS
Policy No:WA763D508631018
Expire : 10/01/2019
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.
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FEES
Bathroom Fixtures
Kitchen Fixtures
Misc.
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
$16.00
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:0
$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:
$51.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance: $51.00
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 f4 t& re9∨s)dnd1catecXelow 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! IQer.ian5vE' d4ry8lis%6r rzpalr 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 4f 4 L){oortions the worhr and lhePstticture 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 j8perty�Mho, thrQugh�riployees'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•cOmplletion, the Owntr-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
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).
❑ 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 have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall,
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://www.leginfo.ca.gov/calow.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti, gn 7000) of Division 3 of the Business and Professions R�yiieense is in full force
and effect �T
License Class License No Date < < Contractor Signature)
COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE 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
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have 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 thI
iffliprmangp-of the work for which this permit is issued. Policy No.
ave and will 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' compensatior
rance carrier and policy number are:
ne of Agent
certify that, in the pf
, if I should become
iature of AoDlicant 4
Policy Number
Date
Ice 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
to thgrworkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r [
11 hereby affirm under pen perjury 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:
I am the property owner or authorized to act on the pr e y owner's behalf.
I have read this application and the information I h e vided is correct. �-
I agree to comply with all applicable city and cou y 91dinancs and state laws relating to building construction.
I authorize representatives of this city or - ro erty for inspection purposes. A � rA
of
ACTION I DATE I BY
LPfRMfTCANCELLED
PERARfTfXTENDfD
OCCUPANCYISSUED
------ Print Prooertv Owner
FEDERAL REGULATIONS FART 61 OF TIILE40AND
AQMD RULE 1403.
❑ ISUBMITf•EOASB€STOSN077F1CATIONTOr
❑ EPA
❑ AQMD
❑ ASBESTOS NORACARONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE.
TILIZIllefU