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Home My WebLink AboutP2021-0553 - Permitsgwr0;? City of Newport Beach - Building Division *P2021-0553` 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 r e.rij"'.. �,,a i '+, c '�- •.,... -..f � � kin PLUMBING Permit: P2021-0553 Project No Inspection Requests Phone (949)644-3255 Job Address: 2106 LEEWARD LN Bldg: 1 Floor: Suite: Description of Work: SFR PLUMB REPLACE SEWER MAIN AND INSTALL CLEANOUT. Inspector Area: 3 Code Edit 2019 Legal Description: N TR 3801 LOT 13 Owner: CARL JOAN LOTA Contractor: DRAIN RIGHT SERVICES INC Worker's Compensation Insurance - ° Address: 2106 LEEWARD LN Address: PO BOX 6943 Carrier: PREFERRED PROFESSIONAL IW,SMI�AN o NEWPORT BEACH, CA 92660 SAN PEDRO CA 90731 Policy No:ON1191101 . Phone: Phone: 310-547-0968 Expire : 1010412022 , Con State Lic:852708 Issued Date:12/17/2021 Lic Expire: 02/28/2023 Bus Lic: BT30077491 Processed By: �� Lic Exp Date: 12/31/2022 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 l) $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 Lndryffrap: 0 $0.00 BackOow, over 2": 0 $0.00 Sewer Alter/Repair:l $39.00 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: $77.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $77.00 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. ER -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 thrd 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 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 oI the o,operty, 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). Ci t ain exempc fro, n licensure under the Contractors' State License Law for the following reason: By my signature bolow 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 legalli sell .. 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 Prufessions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.govlcalaw.html. Signature of P,cp, rJ, Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION ' : crDby affirm urder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions my license is in full force and effect. rr (� j. License Class 7e,e �vc011 License No Date 2 /% Contractor Signature - INURKERS' CUMPENSATION DECLARATION NAPNING FAILURE W 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 :OST OF MMPENS^TION, ^AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 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 e 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: ie of Agent >C c 1 •' certify that, in the performance of the , if I should become subject to the we of Applicant Policy Number Expiration Date 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 provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r I I 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 (Section 3097, Civil Code). Lender's Name Lender's 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to ant r th be -identified property for inspection purposes. _ + Signature of Property Owner or Authorized Agent iCi L; tee. Print Property Owner's or Authorized Agent's_Name� oan q r 1 Date AC77ON DATE BY DECLARATIONOFCOMPLIANCE KITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 61 OF T17LE 40AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD P€RMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOTAPPLICABLETO PROPOSED DEMOLITION. PERMIT FINAL CERTIRCATEOF ^^ , Y" SIGNATURE: OCCUPANCYISSUEO