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Home My WebLink AboutP2021-0010 - PermitsCity of Newport Beach - Building DivisionIIIIIIIIIIIIIIIIIIIIIIIIIIIUIIIIIIIIillllllllll PLUMBING Permit: P2021-0010 a 100 Civic Center Drive, Newport Beach, CA 92660 2 0 2 1 0 e 1 e Project No: 0066-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 1207 BERKSHIRE LN Bldg: 1 Floor: Suite: Description of Work: PLUM/GAS TO BBO/FIREPIT/FIREPLACE. WATERLINE FOR SHOWER & SINK Inspector Area: 3 Code Edit 2019 Legal Description: N TR 3031 LOT 16 Owner: LARKIN Contractor: BLUE PACIFIC POOLS SOUTHERN CALIFORNIA Worker's Compensation Insurance - Address: 1207 BERKSHIRE LN Address: 25108 MARGURITE PKWY #A79 Carrier: STATE COMP INS FUND NEWPORT BEACH, CA 92660 MISSION VIEJO CA 92679 Policy No:9126143 Phone: Phone: 949-310-3196 Expire : 02/28/2022 Con State Lic:923454 Issued Date:01/08/20 1 Lic Expire: 10/31/2022 Toilet: Bus Lic: BT323 Kitchen Sink: Processed By: Lic Exp Date: 01/31/2021/2022. 1 $7.00 Roof Drain: 0 $0.00 $0.00 Bidet 0 5t 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 00o coo • o o 0 0 0 0 o c o e c c o c 00 0 0 oe a oo c c cc e o 0 0 0 0 0 c e o 00o aoo o ccc o 0 0 oca e c o 0 v c or c c c c c 0o eoL o v co occ coe FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 1 $7.00 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: 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 Lndryfrrap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $37.00 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: $44.00 Fee Due at Permit Issuance : $7.00 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 00o coo • o o 0 0 0 0 o c o e c c o c 00 0 0 oe a oo c c cc e o 0 0 0 0 0 c e o 00o aoo o ccc o 0 0 oca e c o 0 v c or c c c c c 0o eoL o v co occ coe 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 py 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 arty structure, prior to its issuance, also requires to 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). a ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 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 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:htlp://www.leginfo.ca.gov/calaw.htmi. 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 Section 7000) of Division 3 of the Business aryd�fessions Code, and my license is in full force and effect. License Class License No Date re) �'� j3 3D Z-1 Contractor Signatu WORKERS' COMPENSATION DECLARATION NARNING: 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 ($100,600), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 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 IN '5erfarmance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Date ne of Agent mune x certify that, in the performance f 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 , if 1 should become subject t6tlle rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. lature of ADDlicant 7 `Ifs Date 3/9'1Z� ;reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (fiction 3097, Civil Code). lder'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 copty ordinance and slate laws relating to building construction. I authorize representatives of this city or coun to er ove-identified property for inspection purposes. / 1�/� mature of Property Owner or Authorized Ag n Print PropertyOwner's or Authorized Agent's Name ( L !l/j ACTION DATE ' BY OECL RATION OF COMPLIANCE WITNCODE OF I FOR OFFICE FEDERAL REGULA TIONS P.4W Q14F IT74EJO4NQ PERMITEXPIRED AQMDRULE1403. • • • • • • .• ❑ / SUBMiTT€DASBESTiOS kO7t7CATIONdCt PERMIT CANCELLED ❑ EPA • ••. ••• PERMITEXTENDED ❑ ADMD ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PERMIT FINAL Z 'Z PROPOSEDDEMOLITN/N. *:0 • • • • • CERTfFICATEOF SIGNATURE: . . • OCCUPANCYISSUED • • • 3lg 0