HomeMy WebLinkAboutp2021-0202 - PermitsCity of Newport Beach - Building Division `P2021-0202`
PLUMBING Permit: P2021-0202
- 100 Civic Center Drive, Newport Beach, CA 92660
Project No
Permit Counter Phone (949)644-3288
AS BUILT PERMIT
Inspection Requests Phone (949)644-3255
EXPOSE ALL STRUCTURAL
Job Address: 6 WATERFORD WAY Bldg: 1Floor: Suite:
7LEL iTz CAL PLUMBING, AND
....
Description of Work: PLUM C/O GAS FITTING FOR BBQ (121-2014)
1.'ANIGAL COMPONENTS
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Inspector Area: 6 Code Edit 2019
Legal Description:
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Owner: ASHRAFIAMIR Contractor: OWNER/BLDR Worker's Compensation
Insurance-
Address: 6 WATERFORD WAY Address:
Carrier:
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NEWPORT BEACH, CA 92657
Policy No:
Phone: Phone:
Expire:
Con State Lic:O/B
IssuedDate:07/01/2021 LicExpire:
BusLic:
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Processed By: � Lic Exp Date:
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
$8.00
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:
$8.00
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/irap:
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:
$54.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance : $54.00
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
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 Hof 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 ,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 riot apply to an ow r property who, through employees' or personal effort, builds or improves the property, provided that the
improvementsVe• not intended or offered for sale. If, however, the bwldmg or,improvement-is sold witKin one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for fhequrpose of sale). -
•.l,.as owner of+ME property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
appfi to an owner of property who builds or improves thereon, and. ho contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
• Lam exempt from licensure under the Contractors' State Lic se La for the fol[oWq reason:
By'My signature.beiow I acknowledge that, except for my persoggi reside ce ineed
c m t have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally
sell a struCtyrptyat I have built as an owner -builder if it has of bee onstrIn i entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
•.Rrofession Code• is available upon request wh this I cation r the following Web site:http://www.leginfo.ca.govlcalaw.html. �/ �/ /
ipgature ofeopeol Owner or Authorized Agent Date ✓mil Z
•••• LICENSED CONT AC OR'S ECLA ATIO
Hereby affirm finder penalty of perjury that I am licensed under provisions of hapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
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effect. • •'
Licensee Class • • • • License No Date Contractor Signature
AbWIEERS' gPfflgNSATION DECLARATION
AARNING: 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 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 art
Trier / 1 I Policv l Lumber Expiration Date
me of Agent
I certify that, in the p
It, if I should become
ermit is issued, I shall not employ any person in any manner so as to become su
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
ignature of Applicant
D.� D
ECLARATION REG DICN
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued
Ender's Name Lender's Address
y my signature below, I certify to each of the follaproperty
I am the property owner or authorized to act oer's be f.
I have read this application and the informatiois Gorr LI agree to comply with all applicable city and cs and tte s tin o building construction.
1 authorize representatives of this city or couno�f d pr for inspection purposes.
ignature of Property Owner or Authorized AgentPrint Property Owner's or Authorized
the workers'
3097, Civil Code).
Name
laws of California, and
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULA7741VSPART 6'1 OFT17LE40ANO
AQMD RULE 1403:
PERMITEX'PIRED
❑ I SUBMITI-EOASBESTOS N077FICATIONTO:.
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS AIOTIRCA770N IS NOT APPLICABLE TO
PROPOSEDDEMOLITION.
PERMIT FINAL
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CERTIFICATEOF
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SIGNATURE:.
OCCUPANCYISSUEO