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Home My WebLink AboutP2022-0061 - PermitsCity of Newport Beach - Building Division I 111�111111111111p11111111111111111p111p11p111111111 d� 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 2 0 0 6 1 F Permit Counter Phone (949)644-3288 Job Address: 2712 HILLTOP DR Bldg: 1 Floor: Suite: Description of Work: SFR PLUMB -REPLACE WATER HEATER AT GARAGE. Inspector Area: 6 Code Edit 2019 Legal Description: 8787 LOT 4 UNIT 54 54A 54P 54B 54D 54GP OF PROJECT LOCATED Owner: LUESEBRINK ERIC Contractor: TOM MOFFETT PLUMBING INC Address: 2712 HILLTOP DR Address: 730 E. DEBRA LN NEWPORT BEACH, CA 92660 ANAHEIM CA 92805 Phone: Phone: 714-541-6407 Con State Lic:827838 Issued Date:03/31/2022 Lie Expire: 10/01/2022 Bus LIC: BT30078739 Processed By: Lic Exp Date: 03131/2023 PLUMBING Permit: P2022-0061 Project No : Inspection Requests Phone (949)644-3255 I ok L_ ••ee a e••e • r Worker's Compensation Insurance- o •'••@ • • o Carrier: SECURITY NATIONAL INSURANOE eO • ° Policy No:SWC1361359 m@ Expire:1113012023 °° m c m 9 mmCA'J • mm••mc 0b 4 • m e O O m O 9 m@ GOm m2 n, 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 $31.00 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 Lndry/Trap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $38.00 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: $69.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $69.00 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 Iicensure 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 exemOfram Iicensure under the Contractors' State License Law for the following reason: By my signature b(WQw l 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) „jP,Il dstructu;e thn 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.html. Signature of PopeAy Owner or Authorized Agent al '..' ' LICENSED CONTRACTOR'S DECLARATION I,herP,by affirrr:uryletpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit action 7000) of Division 3 of the Busine9 nd of is , and my license is in full force • End effect. License Class . . License No Date 3� 31 L2 Contractor Signatu • qQ�� • • • • ERS' COMPENSATION DECLARATION NARNING: FAILURE TPSECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE hUjibRWTHOUSAND DOLLARS 18100,0001, IN ADDITION TO THE GdsYf)FCOMPENSA,TION"MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I?lerebytaffirm L%j %•penalty of perjury one of the following declarations: ' I have and w81 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 oeM"ance of Wort for which this permit is issued. Policy No. have 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' rance carrier and policy number are: mer Policy Number Expiration Date me of Agent ,.��42 Phone # I certify that, in the performa e c t e o rwhich this permit is issued, I shall not employ any person in any manner so as to become subjec 0 d, if I should becom bject t e k compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prod (nature of Applicant Da !CLARATION REG*DINRDVTION LENDING AGENCY areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Se ti Tder'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 o behalf. I have read this application and the information I hoe vi-- is r�. I agree to comply with all applicable city and I authorize representatives of this city or cou ature of Property Owner or Authorized Agar laws relating to building construction. ad property for inspection purposes. Print Property Ownel workers' compensation laws of California, and 31.511 zz 3097, Civil Code). sc,tt PxLICj1¢.V �g n�l�l 3�31/LL ACTION DATE DECLARATION OF COMPLIANCE VIRTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 9403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ASBESPERMIT PROPOSED DOEMOLITION,DONIS NOT APPLICABLE TO FINAL CERTIFICATE OF OCCUPANCYISSUED SIGNATURE: O Z Zm0 y O ti tom T a i CD CD am � � f ib co CD CD ny �0 m � a � O CD O � k y N O O O �o O W N ti CD � c CD 0- nzr l CD. 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