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Home My WebLink AboutP2021-0077 - Permitsywrt,4% City of Newport Beach - Building Division II IIIII IIIIIIIIII III II III IIIIIII III II Gg 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 0 7 7 Permit Counter Phone (949)644-3288 4; ry C r �> '+t rrai4r. Job Address: 23 HARBOR ISLAND Bldg: 1 Floor: Suite: Description of Work: PLUMB/FOR FUTURE INSTALLATION OF SPA EQUIPMENT Inspector Area: 2 Code Edit 2019 Legal Description: TR 802 LOT 23 ALL -INC BET SAME & HIGH TIDE LINE Owner: PICKUP TODD Contractor: FLUID DYNAMICS POOL & SPA Address: 23 HARBOR ISLAND Address: 620 E WALNUT AVE, #B NEWPORT BEACH, CA 92660 FULLERTON CA 92831 Phone: Phone: 714-213-8047 Con State Lic:809954 Issued Date:03/29/2021 Lic Expire: 12/31/2022 Bus Lic: BT30056899 Processed By: Lic Exp Date: 07/3112021 PLUMBING Permit: P2021-0077 Project No : 2708-2019 Inspection Requests Phone (949)644-3255 ®t4s��U� e ON No1se N® Worker's Compensation Insur nce`-.� Carrier: INS CA;OF TiF� Policy (NNVtVO50'49838 Expire-i"08112/2021 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: 1 $31.00 Grease Interceptor:0 $0.00 Bath Tub: 0 $0.00 Vegetable Sink: 0 $0.00 Gas up to 4 outlets: 1 ` $7.00 P-Trap: 1 $15.00 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 LndryfTrap: 0 $0.00 Backflow, over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $37.00 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: $90.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $90.00 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 an( 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 o'' not more 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 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). ❑ 1 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 legal sell a 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 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 an Ions Code, and my license is in full force and effect. Ce� 3(� License Class License No Da�Z-9 /Z Contractor Sicnatur 1 COMPENSATION DECLARATION ARMING: 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 DST 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: 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 ynance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Expiration Date is of Agent Phone # certify that, in the performan f 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 if I should become subjec to workers' provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. lature of Applican n C nP� / Date 'AI` 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 ances and e a s relating to building construction. I authorize representatives of this city or county en above' en'fie roperty for inspection purposes. Signature of Property Owner or Authorized Age �/G Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY F-ELt kAL REGULATIONS PART b7 OF TITLE 40 AND AQM7 ROLE 1403, PERMITEXPIRED tJ ISUBMITTEDASBESTOS NOTIFICATION TO: L] EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ASBESTOS O UPOSED DEMOLITION. OITfONIS NOT APPLICABLE TO PERMIT FINAL ],( �.'S CERTIRCATEOF OCCUPANCYISSUEO SfGMA PURE: