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Home My WebLink AboutP2022-0113 - PermitsCity of Newport Beach - Building Division 111p111111111111111111111111111111111111111111111111111PLUMBING Permit: P2022-0113 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 2 0 1 1 3 Project No Permit Counter Phone (949)644-3288 C Inspection Requests Phone (949)644-3255 Job Address: 1320 BALBOA BLVD W Bldg: 1 Floor: Suite: AS BUILT PERMIT��®?.,� Description of Work: MFR PLUM INSTALLATION OF WET BAR IN DEN *122.1042* 1 EXPOSE ALL STRUCTURAL Inspector Area: 1 Code Edit 2019 Legal Description: TR 234 LOT 6 BLK 113 ELY 30 FT ELECTRICAL PLUMBING, A�fNPmD� Owner: INNOVATIONAL CONCEPTS LLC Contractor: OWNER/BLDR MECHANICAL � cl r Insurance - Address: 118 VIA XANTHE Address: AUTH AGENT: arner : - NEWPORT BEACH, CA 92663 FULLER BRANDON Policy No: , - Phone: 949-292-6941 Phone: 949-292-6941 . Expire: .. Con State Lic:O/B Issued Date:05/2512022 Lic Expire: it Processed By: C 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: 1 $16.00 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: 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: $16.00 Wash Basin: 0 $0.00 Dishwasher: 0 $0.00 Backflow up to 2": 0 $0.00 Sewer: 0 $0.00 Plan Check: $13.92 Hydro -Mass Tub:0 $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: $83.92 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $83.92 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) indi (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, de the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sec not more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of tl Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, througl improvements are not intended or offered for sale. If, however, the building or.improvement is sold within one year of cor improved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors.to construct, the -project (Section 7044, apply to an owner of property who builds or improves thereon, aPd-who contracts for the projects with a licensed Contractc I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one y sell a structure that I have built as an owner-builder'f it has not been constructed in its entirety by licensed contractors. I Professions Code, is available upon requestw ation is submitted or at the following Web t'^ '..r.:...:..• I� Signature of Property Owner or Authorized Agent LICENSED CONT CLARATION hereby affirm under penalty of perjury that I under provisions of Chapter 9 (co w' Ion 7000) and effect. Lirens? Class License No &te 'COMPENSATION DECLARATION 'AENINC: FAILURE TO SSCVRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL OSF OF COM PEN$A-ICN, D %MAGES AS PROVIDED FOR IN SECTION 3T06 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. hereby affirm weer penalty of perjury one of the following declarations: ated below by the checkmark(s) I have placed next to the applicable item(s) Dish, or repair any structure, priorto its issuance, also requires the applicant for aw (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Dn 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, the Owner -Builder will have the burden of proving that it was not built or isiness and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). iderstand that a copy of the applicable law, Se n 7044 o the Busi ss and fiLo.ca.gov/calaw.html. 2 .L Division 3 of the Business and Professions Cod and license is in full force Contractor Signature AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE 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 'ormance of the,vork for which this permit is issued. Policy No. I have and wi'Imaintnin workers' compensation insurance, as required by Section 3700 of the Labor Code, for the ,Iranne carrier and policy number are: rder I I IPolicy Number me of Agent I certify that, in the performance of work for which this permit is issued, I shall not 1, if I should become/s�u�b' o the works om ensation rovisions�of Section Inature of Applicant of the work for which this permit is issued. My workers' Date person in any manner sp as to become subject to the workers' cpppmpen II forthwith omply with those provisiongy! / _ n�tA Ae IECLARATION REG�ftDM ONSTR ON LENDING AGOtPr hereby affirm under enalty that there is a construction lending agency for the performance of the work for which ender's Name Lender's Address y 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 oaws relating to builduction. I authorize representatives of this city or courAyAo a rdi e abo -identified p cr inspection purposes. of Property Owner or Authorized permit is issued Print Property Owner's or Authorized Name ZJ Code). claws of California, and 2Z_ Z ACTION DATE BY" DECLARATION OF COMPLIANCE WfT11 CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF AQMD RULE 1403. ITLE40AND PERMIT EXPIRED ❑ 1 SUBMITTED ASBESTOS NONFIC ❑ EPA ❑ AQMD ITION TO: PERMIT CANCELLED PERA11TEXTEND€D ❑ ASBESTOS NOTIFICA7I0NIS NOT PROPOSED DEMOLITION. APPLICABLE TO PERMIT FINAL CERTIFICATEOF OCCUPANCYiSSUED SIGNATURE: