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Home My WebLink AboutP2021-0287 - Permits«tw�rr4.A City of Newport Beach - Building Division 111p111111111p11111p11111111111p11111p111111Ip 11 ti 100 Civic Center Drive, Newport Beach, CA 92660 P 2 e 2 1 0 2 8 7 Permit Counter Phone (949)644-3288 '[YYf1MA Job Address: 28 SURFSPRAY BLUFF Bldg: 1 Floor: Suite: Description of Work: SFR WATER HEATER C/O IN GARAGE (SAME LOCATION) 75 GAL Inspector Area: 5 Code Edit 2019 Legal Description: Owner: YOUNG JIM Address: 28 SURFSPRAY BLUFF NEWPORT BEACH, CA 92657 Phone: Issued Date:09/13/2021 Processed Bathroom Fixtures Toilet: 0 Bidet 0 Urinal 0 Bath Tub: 0 Shower Stall: 0 Wash Basin: 0 Hydro -Mass Tub:0 Floor Sink: 0 Floor Drain: 0 �1� Contractor: SERVICE CHAMPIONS HTG Address: 3150 E BIRCH BREA CA 92821 Phone: 714-777-7777 Con State Lic:799170 Lic Expire: 10/31/2021 Bus Lic: BT01080105 Lic Exp Date: 0913012021 Kitchen Fixtures $0.00 Kitchen Sink: 0 $0.00 Garbage Disp: 0 $0.00 Bar Sink: 0 $0.00 Vegetable Sink: 0 $0.00 Ice Maker: 0 $0.00 Dishwasher: 0 $0.00 Lndry/Trap: 0 $0.00 Regulator: 0 $0.00 Lawn Sprinkler: 0 TOTAL: $69.00 PLUMBING Permit: P2021-0287 Project No : Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier : EVEREST NATIONAL INS CO Policy No:RM8WC00054201 Expire : 0410112022 �z CJ ) M 0 i 0�ry� .0 FEES Misc. Misc. Other $0.00 Water Piping: 0 $0.00 Roof Drain: 0 $0.00 $O.CC $0.00 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 $0.00 $0.00 Water Heater: 1 $31.00 Grease Interceptor.0 $0.00 $0.00 Gas up to 4 outlets: 0 $0.00 P-Trap: 0 $0.00 Record Mgmt Fee: - $0:00' $0.00 Gas over 4 outlets: 0 $0.00 Sewer Investigation: $O.CA $0.00 Backflow up to 2": 0 $0.00 Sewer: 0 $0.00 Plan Check: $0.00' $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $38.00 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $0.00 $0.00 Drinking Fountain: 0 $0.00 Additional Fee : $0.00 Plan Check Fee : $69.00 Fee Due at Permit Issuance : $0.00 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 farina 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 L) all of or L) 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 Iegall} 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/Galaw.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 Sectio 7000) of Di ision 3 of the Business and Pro essions Code, and license is in full force and effect. Q % License Class License No Date l Contractor Signature/ NORKERE'�COIYPENSATION DECLARATION VARN'NG: 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 'CET 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 nave 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( )i&Wance,oi 1hs 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' car-ier and policy number are: Date ,9 of Agent _ _ certify that„iP the performs e wor which this permit is issued, shall not employ any person in any manner so as to become subject to the worker compensation laws of California, and J I should Pecom%subK ct t he wo rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,., _ _ Iature of Applicam I hereby affirm under pent oerjury 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 pr d is correct. I agree to comply with all applicable city and co my Inances and aws relating to building construction. I authorize representatives of this city or count to en e-identified property for inspection purposes. r �f&d11,M6 61Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name a V 1 Dat/ / ACTION DATECse__�BY DECLARATION OF COMPLIANCE VATH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TIRE 40 AND AQMD ROLE 1403. PERMIT EX PI RED ❑ / SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PER&CTCAAICELLED PERWiTEXTE111DED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT RIVAL CERTrFICATEOF OCCUPANC'YISSUED SIGNATURE: