HomeMy WebLinkAboutP2022-0155 - PermitsL* tw,•„y City of Newport Beach - Building Division `P2022-0155' PLUMBING Permit: P2022-015:
s 100 Civic Center Drive, Newport Beach, CA 92660 Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
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Job Address: 310 HELIOTROPE AVE Bldg: 1 Floor: Suite:
Description of Work: PLUM CHANGE OUT WATER HEATER p\
Inspector Area: 5 Code Edit 2019
Legal Description: CORONA DEL MAR LOT 8 ELK 235 ALL -EX SWLY 25 FT -(AND SWLY 25
FT LOT
Owner: LECHNER KATHLEEN NIVEN Contractor: OWNER/BLDR Worker's Compensation Insurance -
Address: 31871 NATIONAL PARK DR Address: Carrier :
LAGUNA NIGUEL CA 92677 Policy No:
Phone: 949-496-1591 Phone: Expire:
Con State Lic:O/B "
Issued Date:06128/2022 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date: '
"
5
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 Clap:
0
$0.00
Water Softener:
0
$0.00
Grease Trap: 0
$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:
0
$0.00
P-Trap: 0
$0.00
Record Mgmt Fee:
'$'e.OG ,
Shower Stall:
0
$0.00
Ice Maker:
0
$0.00
Gas over 4 outlets:
0
$0.00
Sewer
Investigation:
-SOX i
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:O
$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:
$69.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance : $69.00
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 and
Professions Code) or that he or she is exempt from Ifcensure 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
+Reproved 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
pply 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 licensure under the Contractors' State License Law for the following reason:
By my signature below 1 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 as not b n submconstrue In its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the usiness and
Professions Code, is available upon request when s appho on i or yrthe following Web site:http://www.leginfo.ca.gov/calaw,html. L_? -Z
Signature of Property Owner or Authorized Agent / Dat o
LICENSED CON ACTOR'S biI561 AOTION
I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect.
License Class _ License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WwhM1,r:v. FAILURE Tn 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, nAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
nPreuv affirm under penalty of perjury one of the following declarations:
❑ 1 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 th
performance of the wcrk for which this permit is issued. Policy No.
have 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'
ranee career and policy number are:
Policy Number
of Agent
Date
xrtify that, is 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
it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions,
ignature of Applicant Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
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).
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 coun dinances n state laws relating to building construction.
I authorize representatives of this city or county en r the ab -id ntified property for inspection purposes.
9 1
ignature of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's Name W1�1 v� nNF
ACTION
DATE
BY
DECLARATION OF COMPLIANCE Al TM CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
AOMD RULE 1401
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
— Z
CE,RTIRCATE O F
SIGNATURE:
OCCUPANCYISSUED