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P2021-0304 - Permits
City of Newport Beach - Building Division "P2021-0304" 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 r'�tryviti+l` Job Address: 6 ARBELLA Bldg: 1 Floor: Suite: Description of Work: PLUM WATER HEATER C/O (SAME LOCATION) Inspector Area: 6 Code Edit 2019 Legal Description: Owner: TESORO CREST LLC Contractor: NEWPORT PROPERTY SERVICES INC Address: 6 ARBELLA Address: 4 SUNSET COVE NEWPORT BEACH, CA 92657 NEWPORT BEACH, CA 92657 Phone: Phone: 949-591-8778 Con State Lic:1076056 Issued Date:09/2112021 LRiiceExpire: 3 112023 sic Ixpire: 56 BT300766 By: Date: 09130/2022Processed FEES PLUMBING Permit: P2021-0304 Project No : Inspection Requests Phone (949)644-3255 IN SzF",ECiC;19 Worker's Compensation Insurance - Carrier: NORGUARD Policy No:NEWC273789 Expire : 05/17/2022 Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other "' • . . All $0.00 Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 Roof Drain: 0 $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: 1 $31.00 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:O $0.00 Lndry/Trap: 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: $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 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). 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 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). I am exempt from Iicensure 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 [egad) sell a stm-tire 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 700) of Division 3 of the Business a9d Professions Code, and my license is in full force and effect. / License Class License No Date /2 I , Contractor Signatu 7TC_- WCRKERS' COMPENSATION DECLARATION WARNING: FAILURE TC SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000[, IN ADDITION TO THE C33T OF COMP^1:' A rION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1. reby affirm ender penalty of perjury one of the following declarations: aI 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 rmance cF he Work for which this permit is issued. Policy No. I have and ',v II r.idintain 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' compensation insurance carrier and policy number are: Policy Number of Agent Date I certify that, in the performance of the work 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 agree It, if I should beco ubjec the workers' compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisionS. [nature of Applicant Date "II !CLARA' REG/I�RDI CONSTMICTION LENDING AGENCY areby 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 count rdinances and state laws relating to building construction. I authorize representatives of this city or county t an , above -identified property for inspection purposes. -T (nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name �.T`�`l �A reIVv4,.J Date /Z I/2 ACTION DATE BY DECLARATION OF COMPLIANCEMTH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE4© AND AQMD RULE 1401 ❑ I SUBMITTED ASBESTOS NOTIFICATIONTO: ❑ EPA ❑ AQMD ElASBESTOS NOTIFICARONIS NOTAPPLICABLETO PROPOSED DEMOUTION. SIGNATURE: FOR OFFICE USE ONLY PERMIT EXPIRED PERMIT CANCELLED PERMITEXTENDED PERMIT FINAL - L-L- —2 ( CERTIRCATEOF OCCUPANCYISSUED