HomeMy WebLinkAboutP2018-0195 - PermitsCity of Newport Beach - Building Division 11pil11111p11111111p1111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660
"q Permit Counter Phone (949)644-3288
Job Address: 2 OAK TREE DR Bldg: 1 Floor: Suite:
Description of Work: PLMB -WATER HEATER C/O
Inspector Area: 8 Code Edit 2016
Legal Description: N TR 15389 LOT 8
Owner: DICKINSON TOM
Contractor:
D C DRAINS INC
Address: 2 OAK TREE DR
Address:
P O BOX 1116
NEWPORT BEACH, CA 92660
NEWPORT BEACH CA 92659
Phone:
Phone:
949-642-7531
Con State Lic:763925
Issued Date:
Lic Expire:
06/30/2019
Bus Lic:
BT01020930
Processed By:
Lic Exp Date:
12/31/2018
PLUMBING Permit: P2018-0195
Project No :
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier: EMPLOYEE SERVICE GROUP
Policy No::036150609
Expire : 06/01/2019
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
$Q,QA
Bidet
0
$0.00
Garbage Disp:
0
$0.00
Water Softener:
0
$0.00
Grease Trap: 0
$0.00
WAS °
Urinal
0
$0.00
Bar Sink:
0
$0.00
Water Heater:
1
$15.00
Greaselnterceptor:0
$0.00
°°°o
o°°..
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:%jf0.®0
°
Shower Stall:
0
$0.00
Ice Maker:
0
$0.00
Gas over 4 outlets:
0
$0.00
Sewer
Investigation:
t0.00
Wash Basin:
0
$0.00
Dishwasher:
0
$0.00
Backflow, up to 2":
0
$0.00
Sewer: 0
$0.00
Plan Check:
Hydro -Mass Tub:
0
$0.00
Lndrylfrap:
0
$0.00
Backflow over 2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
..M00
0.$33.00
°° °°°
Floor Sink:
0
$0.00
Regulator:
0
$0.00
Hose Bibb:
0
$0.00
Sewer Abandon: 0
$0.00
Supplemental Fee:
..tAt)t)
° • °
Floor Drain:
0
$0.00
Lawn Sprinkler:
0
$0.00
Drinking Fountain:
0
$0.00
Additional Fee :
$0.00
° °°°
°....
TOTAL:
$48.00
Plan Check Fee:
$48.00
Fee Due at Permit Issuance: $0.00
°
°
o • • mao°�
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).
111, 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:http://www.leginfo.ca.gov/calaw.html.
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 arAProfessions C/a , and my license is in full force
and effect. �^ / U1(
License Class License No Date l9 Contractor Signa
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 HU RED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 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 th
04flormance of the work for which this permit is issued. Policy No.
- I eve 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' compensatiol
insu ante carrier and policy number are:
Pnliry Numhar Expiration Date
ie of -Agent
.. • • —rases
certify that, :, t%9i
,if Nhould become
rature of ApplicaRt-
lhereb9 affirm
I of the work f 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
the worke mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ) )
e .-A
lending agency for the performance of the work for which this permit is issueV(S)Bction 3097, Civil Code).
Lender's Address
ly my Signature below, I certify to each of the following:
• • 1 amdhe property owner or authorized to act on the property owner's behalf.
T have read Ki6appiication and the information I have provided is correct.
•.I agree to comply AM all applicable city and county ordinances and fate laws relating to building construction.
• 1 authorize raorasersatives of this city or county to nt r the a ar e'eptified property for inspection purposes.
AC770N
DATE
V BY
DECLARATION OF COMPLIANCEIMTH CODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQMDRULE 1403.
PERMIT EXPIRED
❑ i SUBMfTrEDASSESTOS M077FICATION TO:
❑ EPA
❑ AQUD
PERMITCANCELLED
PERA41TEXTENDED
[3 ASBESTOS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMITFINAL
/
S Ck
CERTIFICATEOF
t
OCCUPANCYISSUED