HomeMy WebLinkAboutP2020-0007 - Permits�+$r City of Newport Beach - Building Division IIIII�IIIIII�IIIIII�IIII�IIIIIIII�IIII II
w't 100 Civic Center Ddve, Newport Beach, CA 92660 P 2 0 2 0 0 0 0 7
Permit Counter Phone (949)644-3288
Job Address: 3408 MARCUS AVE Bldg: 1 Floor: Suite:
Description of Work: MFR (2) WATER HEATER CHANGE OUTS (SAME LOCATION)
Inspector Area: 1 Code Edit 2016
Legal Description: CANAL SECTION BILK 334 LOT 5
Owner: WU ERIC Contractor: OWNER/BLDR
Address: 1206 E LEXINGTON AVE Address: AUTH AGENT:
POMONA CA 91766 NATHAN PHILLIPS
Phone: 909-538-7347 Phone:
Con State Lic:O/B
Issued Date:01/14/2020 Lie Expire:
c �/� Bus Lie:
t
Processed By: So - `. Lie Exp Date:
PLUMBING Permit: P2020-0007
Project No: 2701-2017
Inspection Requests Phone (949)644-3255
INSPr.CT®
°
Worker's Compensation Insurance -
Carrier:
Policy No:
°m
Expire:
°
NO
CONSTRU
FEES
uIv I t1E WEEKEND,
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:
2
$34.00
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:
$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:
$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 TOO a.m, to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
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).
RI, as owner of the property, or my employees with wages as their sole compensation, will do U 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"Iho 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 oumet of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
5�a am ex. VJ Dtm licensure under the Contractors' State License Law for the following reason:
By nfy 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 legalt,
sell a structure that I have built as an owner -builder i.t.hST_r'WbeeVFbVstructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 744 of the Business and
' .LHofession%Cod%, is available upon request when s appli ion is su mitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of-RrepAt* Owner or Authorized Agent Date
•••• ••• LICENSED CONT CTOR' 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 Professions Code, and my license is in full force
'•and effect. '•••
L1it0dse Class License No Date Contractor Signature
fflC)MZERS' GONIPtNSATION DECLARATION
NARNING: FAILURETC 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
$%S M- OMPENS411" DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
'heretry affirm dndeDpenalty 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
)erformance of the work 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:
Policy Number
of Agent Phone #
Date
I certify that, in the performan e r for hich 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 agre
that, if I should become ZING
ctto the orkers' co ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision
Signature of Applicant Date
DECLARATION REG CO TRUCTION ENDING AGENCY
I hereby affirm under enalty 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).
Lender's Name Lenders Address
By 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 rSyRep s an state laws relating to building construction.
I authorize representatives of this city or county to Ater ff above dentified property for inspection purposes. 1 i `
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 1 `�'�" A.\) Y�14(1%,S Date
ACRON
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OFTITLE40AND
AQMD RULE 1403.
PERA41TEXPIRED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERA41TEXTEFJDED
❑ ASBESTOS N01IRC47IONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMTTRIVAL
Z
CER77FICATEOF
SIGNATURE:
OCCUPANCYISSUED