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Home My WebLink AboutP2019-0337 - PermitsCity of Newport Beach - Building Division 111111111111111111IIIII�III III�IIIIIIII�IIII II II PLUMBING Permit: P2019-0337 w4, 100 Civic Center Drive: Newport Beach, CA 92660 P 2 0 1 9 0 3 3 7 Project No: 0792-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 123 JASMINE CREEK DR Bldg: 1 Floor: Suite: Description of Work: PLUMB/BBQ (<42")co Inspector Area: 4 Code Edit 2016 �7 Legal Description: N TR 7967 LOT 72 1 + 1 Owner: BENTROTT BRYAN Contractor: M S N POOL PLASTERING Worker's Compensation Insurance - Address: 123 JASMINE CREEK DR Address: 15660 YOUNGWOOD DR Carrier: STATE FUND CDM CA 92625 WHITTIER CA 90603 Policy No:9093061 Phone: Phone: 562-756-3841 Expire: 03/21/2020 Con State Lic:969647 0 Issued Date:12/09/2019 Lie Expire: 01/31/2020 5y*--� Bus Lie: BT30047389 Processed By: Lic Exp Date: 06/30/2020 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: 1 $7.00 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 Lndryrirap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $35.00 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: $42.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $42.00 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. •s- c®• a• su♦ a• o♦ a u a ® ac 0 0•♦ ♦♦ 4 D 6 oe e e e a o-a a � v a a♦ e �.o ♦ oeo 00 c ee ♦ e aao cr 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 U 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 1 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 legalf, 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://w .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 PmfessigFflCode, and my license is in full force and effect. - License Class License No _Za 1l�c V-X Date ' Contractor Signature�/��/ WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE 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 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under 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 th P14ormance of the work for which this permit is issued. Policy No. have and will tain 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 ad picy number ( A ier _ A 1 �%ic' � t fy r Expiration Date 1e of Agent 1 "- certify that, in the performance of . if I should become sulmect to the of Applicant 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 compensation proy*ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions., , :reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 county ordina es and state laws relating to building construction. I authorize representatives of this city or cou*fo ente above-identifie"roperty for inspection purposes. ACT70N DATE RY DECLARATION OF COMPLIANCE WITH CODEOF FOR OFFICE USE ONLY FEDERAt.KQQLAT1ONS PART 61 OF-WL*q40AND AQMDRULE19903. :. • • ❑ I WMITkDASBESTOS JOf1FVW1012 j0: i • a PERMITEXPMED PERMITCArNCELLED .IEPA:" ❑ AQMD PERMITEXTENDED ASBESTOS P❑ROPOSFJ1DFAWL1TION. * LS . .APPLICABLE TO 'E: . s . s . $IONATULa m• e m e e e PERMITFINAL /O �Zj• �'~ '�' • CERTIFICATE OF OCCUPAAJCYISSUED c e • a s o e • oe eo •o•