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Home My WebLink AboutP2021-0262 - Permits-, City of Newport Beach - Building Division *P2021 -0262* 100 Civic Center Drive, Newport Beach, CA 92660 I Permit Counter Phone (949)644-3288 e-4r5sia` Job Address: 137 MILFORD DR Bldg: 1 Floor: Suite: Description of Work: PLMB - R/R GAS LINE FROM METER TO HOUSE Inspector Area: 5 Code Edit 2019 Legal Description: N TR 3357 LOT 163 Owner: KAZER ROBERT CRAIG Contractor: RELIABLE ROOTER & PLUMBING INC Address: 137 MILFORD DR Address: 2925 COLLEGE AVE, #A-7 CORONA DEL MAR, CA 92625 COSTA MESA CA 92626 Phone: Phone: 949-673-5600 Con State Lic:753331 Issued Date:08/18/2021 Lic Expire: 05/31/2022 Bus Lic: BT30031693 Processed By: Lic Exp Date: 04/30/2022 PLUMBING Permit: P2021-0262 Project No : Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier : HARTFORD. FIRE Policy No:72WECZS8181 'Expire: 11/01/2021 FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc.`' 0 $0.00 Other $0.00 Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 Roof Drain: $0.00 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 Urinal 0 $0.00 Bar Sink: 0 $0.00 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: 1 $8.00 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: Fee: $38.00 $0.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 Additional Fee: $0.00 TOTAL: $46.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $46.00 PERMITS EXPIRE 190 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. c: o ��•. � �cc o 0 c c a o 0 J � o � t Q, O n F7 ry ty � xV Cp � � n 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 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 untended 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). ❑ 1, 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 propefiy, who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 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 legally sell a structure that l 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.govlcalaw.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 Sec on 7 00) of Division 3 of the Business and Pr es ,ions Code, an license is in full fo e and effect. License Class License No Date N Contractor Signature e/ WORKERS' COMPENSATION DECLARATION L 1 NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty''of perjury one of the following declarations: 'I have and will mai'ntain� 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 of the work for which this permit is issued. Policy No. ave and will mainworkers' 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 ranee carrier and policy ,'number are: carrier Policy Number Expiration Date Vame of Agent Phone # DI 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 :hat, if I should become subject to the rk s' compensation proy ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �/ 1 Signature of Applicant Date DECLARATION REGARDING'NC( D75TRu ION LENDING AGEN U` f hereby affirm under penaltylof perjury that there 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 3y 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 coun' o ennr t' e above -identified pr e for ins ection purposes. , Signature of Prooertv Owner or Authorized Agent ! I / "� - 1 rint Prooertv Owner's or Authorized Agent's Names COIL 'L Date AC77O +l DATE BY DECLARATION OF COMPLIANCE t TH CODE OF FOR OFFICE USE OJVLY FEDERAL REGULATIONS PART 61 OF TITLE _40AMG _ AOdl DRULE 1403 , PE' "�?t; EXP,FIIEL ® I SUBMITTED ASBESTOS N077FICATION.,Tt; ® EPA ® AQMD }��,�,�r ,�^ `y^ }fir ,IT SC—f4 Af CEiL ELI? -I rPEM' PER�"U LEXTE5dDED' �I ® ASBESTOS N077FICA77ONIS NOT APPLICABLE TO PROPOSED DEMOLITIOI`J PEfs'WIT FINAL CERPFICATE OF V SIGNATURE; .. , . 1 (�( ��g �gp �* p }'(p n