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Home My WebLink AboutP2016-0368 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111111 11 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 6 0 3 6 8 Permit Counter Phone (949)644-3288 Job Address: 1201 BERKSHIRE LN Bldg: 1 Floor: Suite: Description of Work: PLUM -WATER HEATER C/O Inspector Area: 3 Code Edit 2013 Legal Description: N TR 3031 LOT 15 Owner: TORRES LUKE Contractor: EVANS PLUMBING SERVICES INC Address: 1201 BERKSHIRE LN Address: 1720 WHITTIER AVE NEWPORT BEACH, CA 92660 FEES COSTA MESA CA 92627 Phone: Phone: 714-240-3048 ° Kitchen Fixtures Con State Lic:994516 Issued Date:07/0612016 Lic Expi e: 07/31/2016 Other Bu BT00007441 Processed By: is Exp Date: 12/31/2016 PLUMBING Permit: P2016-0368 Project No : Inspection Requests Phone (949)644-3255 WIN 2 Worker's Compensation Insurance - Carrier: REPUBLIC UNDERWRITERS INS ° Policy No:ATW00172703 Expire: 01/01/2017 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION ° FEES ° ° PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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:0 $0.00 Lndrylirap: 0 $0.00 Backflow, overt": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $32.00 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: $47.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $47.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION )WNER-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 lot more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U 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). I, as ownergftbe 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 t yJggr df property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ ham exgmpf fwvn licensure under the Contractors' State License Law for the following reason: VA; signatare•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 legal) spil 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 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/calaw.html. Signature of P?C"Tty Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I Re4eby affirmarift; penalty of perjury that I am licensed under provisions of Chapter 9 (commencingpith Sec' 7000) of Division 3 of the Business d Profe ns Code, license is in full force • • 9rtc.effect.. Lieonse Class License No D "l Contractor Signatur MQRKERS' COMPENSATION DECLARATION ... TO THE YARNING°: FAILUR�•TO •5EOURE 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 :QIT.QF.COMPENSATION+ DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I�efgaWaffirm ander eenalty of perjury one of the following declarations: 7 1 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 the el#onfiaNce of the work for which this permit is issued. Policy No. hand 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' carrier and policy number are: Date is of Agent certify that, in the performance of work for if I should beco subject to workers' co lature of Applica is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and lions of Section 3700 of the Labor Code, I shall forthwith comply with those pro0ions. ;reby affirm under penalty of perjury that there is a onstruc Ion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 ordinances and state laws relating to building construction. I authorize representatives of this city or countyrnter the above -identified property for inspection purposes. //n�,,' nature of Prooertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam€ \ n L—U l ACnDN DATE BY DECLARATION OFCOMPLIANCEWITNCODEOF I FOR FFOFRAL RFGULATIONSPART O1 OFTITLE40AND PERMITEXPIRED ❑ I SUBMITTED ASBESTOS NouncATION TO: ❑ EPA [3 AOMD ❑ ASBESTOS NO117RCABONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMfTCANCEILED PERMITEXrENDfD PERMIT FINAL . ?j Q CER77FICATEOF OCLUPANCYLSSUED