The URL can be used to link to this page

Home My WebLink AboutP2022-0159 - Permits(9) City of Newport Beach -Building Division 11�1111 1111111111111111111111111111111111111111111 111111 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 2 0 1 5 9 Permit Counter Phone (949)644-3288 Job Address: 1950 GALAXY DR Bldg: 1 Floor: Description of Work: GAS LINE TO BBQ Inspector Area: 3 Code Edit 2019 Legal Description: N TR 4224 LOT 17 Owner: ZMIJEWSKI JEANETTE Address: 1950 GALAXY DR NEWPORT BEACH, CA 92660 Phone: Issued Date:07105/2022 Processed By: MA Suite: Contractor: WATERWORX POOLS INC Address: 202 FASHION LN STE 219 TUSTIN, CA 92780 Phone: 714-714.0424 Con State Lic:1059336 Lic Expire: 10/31/2023 Bus Lic: BT30074831 Lic Exp Date: 03/31/2023 PLUMBING Permit: P2022-0159 Project No : 2889-2021 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier : CAROLINA CASUALTY Policy No:BNUWC0154761 Expire : 08/02/2022 rr , 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: 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: $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: $46.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $46.00 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. I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason (a) 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 (_) 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). ❑ 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 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://w .leginfo.ca.gov/calaw, html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION 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 Professions an Is in f o and effect. b Z Z License Class License No Date 2 Contractor Signature41 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. I hereby affirm under penalty of perjury one of the following declarations: 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 the pe mance 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: arrier Policy Number ame of Agent �I certify that, in the performance of thew r which this permit is is �I s — not employ at, if I should become subject to the s' C ens n pro ' ns of ton 3700 of the I ignature of Applicant I/ ,�e hereby affirm under penalty ofperjury that there is a construction lending agency for the performance of 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. agree to comply with all applicable city and county ordinances t aws r ling to build I authorize representatives of this city or county to enter t entifie operty for' ion p ignature of Property Owner or Authorized Agent IC Goo ii irlwtxr"�� Date manner so as to become subject to the workers' compensation laws of California, and forthwith comply with those provisions. work for which this permit is issued (Section 3097, -+", ACTION DATE BY DECLARATIONOF COMPLIANCE IMTH CODEOF FOR OFFICE USE ONLY FEDERIL REGUL 4TICIPS PART fit OF TITLE 40 AND AOh^D RULE f4G3. PERMIT EXPfREO D /Sti3MI. IED) SCESTCS NOTIFICATfON TO: ❑ EPA ❑ AOMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROF=ED DEMOJTIOA'. PERMIT FINAL CERTIFICATE OF SIGNATURE:. OCCUPANCYtSSUED