HomeMy WebLinkAboutP2022-0067 - PermitsCity of Newport Beach - Building Division 11111111111111p111111111111111111p111p111111111p 11
100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 2 0 0 6 7
. v Permit Counter Phone (949)644-3288
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Job Address: 1516 SANDCASTLE DR Bldg: 1 Floor: Suite:
Description of Work: PLUM WATER HEATER CHANGE OUT
Inspector Area: 6 Code Edit 2019
Legal Description: N TR 6152 LOT 50
Owner: ZALESKI MARGARET
Contractor: OWNER/BLDR
Address: 1516 SANDCASTLE DR
Address:
CORONA DEL MAR, CA 92625
Phone: _
Phone: 949-640-8642
Con State LIc:O/B
Issued Date:04/05/2022
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
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PLUMBING Permit: P2022-0067
Project No:
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier :
Policy No:
Expire : m m e m
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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
LndryfTrap:
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 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).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale '�Saction 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).
as owner pi" property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
p an mvpe(gf property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
Ihm exeg" from licensure under the Contractors' State License Law for the following reason:
�y my signature pCIVV 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
sa11 a structure that I have built as an owner -build 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
• Prdfessions Code, is available upon request this plication is ubmitt4 or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Sign. Lure of �IUQeltwOwner or Authorized Agent i / S .lz'` Date i�✓��`!J 2
LICENSED CONTAAOR'"ECLARARON
' hereby affirwl•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, an my license is in full force
••9r1d,effect.: •..•
�L•iee nbe Class License No Date Contractor Signature
POMR ERS' COMPENSATION DECLARATION
$YARNING: FAILUREJO%EGURE WORKERS' COMPENSATION COVERAGE 15 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.COMPENSATIONi DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
14%re6y affirm mn per penalty of perjury one of the following declarations:
I 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
performance of the work for which this permit is issued. Policy No.
I 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'
urance carrier and policy number are:
of Agent
Policy Number Expiration Date
Phone #
I certify that, in the 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
t, if I should become subject the workers' compensation
prop .sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisiion
(nature of ADolicant G9G�,>-u✓�.. ��./Aa;F Date
:reby affirm under penalty of pelrjury that there is a construction lending agency for the performance of the work for which this permit is issued (S6ctbn 3097, Civil Code).
Ider's Name Lender's Address l
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 cou ty toJJ��,, ter the abov -identified pr ertyy,rrJJfor inspection purposes.
nature of Property Owner or Authorized Agenk U , a,.,.._7r%�% �y�e e't�� Print Property Owner's or Authorized Agent's Name a Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR 6FFICE USE ONLY
FEDERAL REGULATIONS PART 51 OF TITLE 40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTEDASBESTOS NOTIFICATION' TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT: EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
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CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED
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