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HomeMy WebLinkAboutP2018-0213 - PermitsCity of Newport Beach - Building Division *P2018-0213* 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 si PLUMBING Permit: P2018-0213 Project No: Inspection Requests Phone (949)644-3255 Job Address: 2005 BARRANCA Bldg: 1 Floor: Suite: Description of Work: PLUM SEWER CLEAN OUT •O m - Inspector Area: 8 Code Edit 2016 Legal Description: TR 6227 (L.L.84-214032) PAR 29 FEES Owner: THE BLUFFS HOA Contractor: ROTO ROOTER SERV Worker's Compensation Insurance - Address: 2141 VISTA DEL ORO Address: 23311 MADERO Carrier: FEDERAL INS Kitchen Fixtures ° NEWPORT BEACH, CA 92660 MISSION VIEJO CA 92691 Phone: Policy No:54309480 • m `°°• •°° Phone: 949-380-4161 Expire : 08/01/2018 ° Con State Lie: 1016021 $0.00 • m , • m o Issued Date:06/15/2018 Lie Expire: 07/31/2018 Water Piping: •^ y. • • z � o Bus Lie: 8730057895 g $0.00 »�,..;,. ° • • o o Processed By: Lie Exp Date: 02/28/2019 0 $0.00 ®• •e 0 $0.00 m ° 0 $0.00 Grease Trap: 0 m • o $0.00 Urinal m• • D6mP00 Bar Sink: 0 m m m O 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 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: 0 $0.00 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 Lndryfrrap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:l $33.00 Issuance: $33.00 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: $66.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $66.00 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 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 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 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 eaep pj pm 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 str*TLJ9 Nt I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Piofessims CCtle, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ' $igllature of Property Owner or Authorized Agent Date • • LICENSED CONTRACTOR'S DECLARATION • I hereby aff PA uMor penalty of perjury that I am licensed under provisions of Chapter 9 (commencing Ith Se on 70 0) of Division 3 of the Busines ssions Code, and my license is in full force •.and effect, • , , Jyr�Dse Class License No D / Contractor Signa WORkERS' CQMPENSATION DECLARATION YyNW W6: FAILURF�TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE C06T OP�COMPEd IOU/DAM AGES As PROVIDEDFOR IN SECTION 3705 OF THE LAB OR CODE, INTER EST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: . .. .I.hEve and•�yitl ry9intain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 370.0 of the Labor Cade, for th( e(rformanca of a work for which this permit is issued. Policy No. (LlL4ave 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 insurance carrier and policy number are: Policy Number Date is of Agent riwim n certify that, in the perfor5nance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to , if I should become sulferN the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provis) nature of Applicant CLARATION REG#ftWG CONSTRUCTION LENDING AGENCY rreby affirm underfpenalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued 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 coun ' 16 ces and state laws relating to building construction. I authorize representatives of this city or count enter th above -identified property for inspection purposes. nature of Pmnertv Owner or Authorized Aoen -, Print Property Owner's or Authorized Agent's Nam ACTION DATE / BY utl.tt rive yr c.vinruNwL-c rrrrn wvr_vr FEDERAL REGULATIONS PART 61 OFT/RE40AN© P€RMITEXPIRED AOMDRULE1403. I SUBMfTrEDASBESTOS NOTIFICATION TO: PERMITCANCFLLED ❑ EPA P€RMITEXTENDED❑ AOMD or ❑ ASBESTOS N07IFICAT/ONIS NOTAPPLICABL.E TO PERMIT FINAL PROPOSED DEMOLITION. CERTIFICAT€OF SIGNATURE, OCCDPANCYISSUED workers' compensation laws of California, and 3097, Civil Code). FrOZ