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Home My WebLink AboutP2017-0472 - Permits� � City of Newport Beach - Building Division. �uilmi��i��II�IIu�II��II�III�I IPLUMBING Permit: P2017-0472 100 Civic Center Drive, Newport Beach, CA 92660 sill P 2 0 1 7 0 4 7 2 Project No : 1424-2014 `' Permit Counter Phone (949)644-3288 0`4ktriaug Inspection Requests Phone (949)644-3255 Job Address: 2961 CLIFF DR Bldg: 1 Floor: Suite: Description of Work: PLUM/TEMP GASLINE TO POOL HOUSE X2014-1793 InspectorArea: 2 Cade Edit2016 Legal Description: FIRST ADD TO NEWPORT HEIGHTS LOT BILK Z PARK 1 Owner: H VID Contractor: TEAM ULTIMO REAL ESTATE Worker's Compensation Insurance - Address: 61 CLIFF DR Address: 1529 MAXWELL WAY Carrier: STATE COMP NEWPORT EACH, CA 92663 COSTA MESA CA 92627 Policy No:9051279 Phon Phone: 949-689-5293 Expire : 04/01/2018 Con State Lic:964742 Iss ed ate:10/25/20 Lic Expire: 08/31/2019 Bus Lic: BT30036733 Pro ess d By: Lic Exp Date: 08/31/2018 ° 'O°O° ® 6000GG 0°00 O O FEES Bathroom ixtures Kitchen Fixtures Misc. Misc. Other V. ° 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 1001- 0 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 $6.00 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 $0.00 Sewer Investigation: %$y,AO 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 Lndry/Trap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: .0.60.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $9.00 Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 Additional Fee : $0.00 TOTAL: $15.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $15.00 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. All OWNER -BUILDER DECLARATION j I hereby affirm under penalty of perjury that I am exempt TromZ - .._.ltractors' 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 vlolation.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 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 legally 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/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 and Professions Code, and my license is in full force and effect. _. License Class License No Date iG 25 i$ Contractor Signatuf��/��`—v i WORKERS' COMPENSATION DECLARATION k WARNING: FAILURE TO SECCOO,RE 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 COST OF COMPENSA`I"ION, *MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. the rebypffirm under penalty of perjury one of the following declarations: e 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 thf p gr pe of the Work for which this permit is issued. Policy No. have nd wjlRniillllin 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 insuran carrier and poiicy number are: • r ••• • Policy Number Expiration Date Naamemeof Agent .. Phone# o 6rgltjfy that, in ttfe performance 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 agree tlt,1f I sliould beCryge• §ubject to the workers' cornpensation.prayisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date 16/7-5�1'�- IPCLARATION kEGA�DING CONS'IRUC'TfON LENDING AGENCY hereby affirm uncfer p alty of perjury that there is a construction lending agency for the performance of the work for which this permit is 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 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 coucthe above=idetttlfie pro y for inspection purposes. innnture of Pronertv Owner or Authorized AGent Print Property Owner's Or Authorized Agen 3097, Civil Code). ACTION DATE BY ucu.0 fiver vrrrrrn 1.w v.- r......rr.�......—, FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1403. ❑ I SUBMITTEDASSESTOS NO77FTCATION TOr ❑ EPA ❑ AQMD PERMITEXPIRED PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIFICA710N1S NOTAPPLICABLE TO PROPOSEDDEMOLITTON. SIGNATURE: PFA VTFINAL - %/ CERTfRCATE OF OCC(/PANCYISSUED