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Home My WebLink AboutP2021-0540 - Permits,..,T City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II PLUMBING Permit: P2021-0540 L 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 5 4 0 Project No Permit Counter Phone (949)644-3288 - k �dceriiY+`''` Inspection RequestSfPhone (949)644-3255 Job Address: 301 HARBOR WOODS PL Bldg: 1 Floor: Suite: r Description of Work: PLUMB/CHANGE OUT (E) WATER HEATER Inspector Area: 6 Code Edit 219 458-311-08 �r �y9 Legal Description: TR 11935 LOT 3 UNIT 301 OF PROJECT LOCATED ON AP TOGETHER ri1 Owner: GULLOTTO VINCENT Contractor: NEXGEN PLUMBING & DRAIN SERVICE INC Worker's Compensation Insurance - Address: 2549 EASTBLUFF DR Address: 700 NORTH VALLEY ST SUITE K Carrier: OLD REPUBLIC NEWPORT BEACH, CA 92660 ANAHEIM, CA 92801 Policy No:A1 CWA001 1502 Phone: Phone: 855-580-0007 Expire : 01/2912022 Con State Lic:1048123 Di Issued Date:12/08/2021 Lic Expire: Bus Lic: BT30055503 Processed By: v Lic Exp Date: 06/30/2022 FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Drain: 0 $0.00 Other $0.00 Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 Roof 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 $0.00 Wash Basin: 0 $0.00 Dishwasher: 0 $0.00 Backflow up to 2": 0 $0.00 Sewer: 0 $0.00 Plan Check: $38.00 Hydro -Mass Tub:0 $0.00 Lndry/Trap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: 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 - Fridey 7:00 1. m, to 6,30 p.•n. and 3v*ur4m, 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 notmore than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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). ❑ I am exempt from licensure 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 legall,, sell a structure that I have built as an owner -builder if it has not been constructedin 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.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 Profe ' ns my license is in full force and effect. License Class License No Date � Contractor Signatur WORKERS' COMPENSATION DECLARATION NARNING: 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. hereby affirm under penalty of perjury one of the following declarations: 111 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 oer;ormance of the work for which this permit is issued. Policy No. have and will ntain 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 nd licy numbe /'' ier -. I n n . 1 \P�licy Nymy�r, _ Expiration Date of Agent certify that, in the performance of the work for which this permit is d, tshell not employ any person in any manner so as to become subject to the workers' compensation laws of California, and , if I should become subject tope worker�pensatIsions of Section 3700 of the Labor Code, I shall forthwith comply with those pro si s. , I P , Iignature of Applicant bate X Girl e / G IECLARATION REG DI CON TIO NDING AGENCY - �� hereby affirm under penalty of ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address ly 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 ordinan s and state laws relating to building construction. �7 I authorize representatives of this city or county to en;er the ab -iden e y for inspection purposes. Print Property Owner's or Authorized Agent's Name ACT701V DATE BY DECLARATION OF COMPLIANCE YVITN CODE OF -- FFDERAL REGO ATIONS.PAP-T.F-1 OF TITLE40 AND � QMD RULE 140. ❑ I'_'UEMITTEDAS3ESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NO TIRCA RON IS NOT APPLICABLE TO PPOPOSED DEMPLITION SI3NATVRE: FOR OFFICE USE ONLY PERMIT EXPIRED PERM?TCANCEUED PERA41T EXTENDED PERMIT FINAL -ZZ ti 7 CERTIFICATEOF OCCUPANCYISSU€D