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Home My WebLink AboutP2015-0278 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive. Nev,,-.�rt Beach, CA 92660 F y Permit Counter Phone (949)644-3288 ;o u � Job Address: 432 ISABELLA TER Bldg: 1 Floor: Suite: Description of Work: PLUMB/CHANGE OUT (E) WATER HEATER- TO TAN Inspector Area: 5 Code Edit 2013 Legal Description: TR 1237 LOT 155 FOR OF LOT(AND FOR OF 156 Owner: RANDALL JR. FREDERIC A Contr GREENS Address: 432 ISABELLA TER ass: 5 All CORONA DEL MAR, CA 9262 NGE C1 Phone: �l)yn 949 880 Issued Date:06/09/201 Processed Bathroom Fixtures Toilet: 0 Bidet 0 Urinal 0 Bath Tub: 0 Shower Stall: 0 Wash Basin: 0 Hydro -Mass Tub:O Floor Sink: 0 Floor Drain: 0 $0.00--`;etc n Silk $0.00 `6 rb a Di $0.00 Br;Si $0.00 Ve jefab $0.00 Ice (Wake $0.00 Dishwashe $0.00 Lndry/Trap: $0.00 Regulator: $0.00 Lawn Sprin TOTAL: $50.00 Bus 16 \V- �{ aka o10 ®►- FEES 'misc. )io 0Water Pipin9$0.00 00WaterSo 15r� $0.00 .00 Wa e i 1 $15.00 0 $ .00 0, 0 $0.00 0 .0 ov_es: t 0 $0. 0 0 Ba tl�rup to 2": 0 .00 0 ow overt": $0.00 0 `v Hose Bibb: 0^ 0 $0.00 Drinkin untain: $50.00 BING Permit: P2015 No Requests Phone (949)644-3255 Worker's Compensation Insurance Carrier: EMPLOYEE SVC GR' Policy No:434987 Expire: 07/01/2dl6 e� G��d NE .v SCo"N Misc. Roof Drain: Grease T 0 701? matr: $0.00 Record Mgmt Fee: $0.00 Se Investigation: $0.00 0 $0.00 Plan Check: $0.00 Alter/Repair:0 $0.00 Issuance: $35.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $0.00 Additional Fee : $0.00 Fee Due at Permit Issuance : $0.00 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any u , prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter mencln with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section Z2,%$,i80Uy any applicant r a permit subjects the applicant to a civil penalty of iot more than five hundred dollars ($500). J I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) p of the work, and the structure is Vo 'ntended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of pro o, throng loyees' or persopal¢ rt,\ve or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is s in one �yeera^r\q, bnn, the O,�yreV r will he burden of proving that it was not built or improved for the purpose of sale), ` Q'"'1'0I, as owner of the property, am exclusively contracting with licensed Contracto onstruct the project ection 70��44 ��iiyyss sand Professions Co Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who c s for the projects with a license t;pGMY�atoYpursuant to thecense Law). ❑ am exempt from licensure under the Contractors ' State Li aw for the followin son : DD`�� 3y my signature below I acknowledge that, except for my al residence in whi ust have resided for at least sell a structure that I have built as an owner-bui as t been con ad in its entirety by licensed contras Professions rbae, Is available upon re t is pp n' mitted or,at-the following Web site;htkov Signature of Property Owner or Aut Agent _ I hereby affirm inc and effect. License Class >RNING: FAILURE Yl SECURE' )-I GF COMPENSATI01 D..MA ,uaL} affirm under penajt I have and will mairtail irformaoce of tiiu wok for have and wi'kmaictain urance carrier, add. policy is of Agent certify that, in the pc if I should become iature of Applicant completion of the improveekents covered by this perm I that a copy of the applicablil law, Section 7044 of the of perjjuuht Iac nsed under provisions of Chapter 9 (commencing with Se tion 7000) of Division 3 of the Business and 100 License No Date %` Contractor Signature ODE ATION tKERN S OMPENSATION COVERAGE 15 UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO b,. MINAL PENALTIES AND( i[Revke4 INEdP TOAS PR IDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.\(V�'erju ne ), -following declaratops(/.�ifica conse t to self Insurefo mpensation, issued by t it or �IShilprovided his peSo'licv 'olicy No, yx, a comari required by Section 3700 of the Labor r thk?0o*19nce of the work for l�iSer re: ��" �`. Number _X C\ ation Da :Aes hereby affirm under penalty of perjury that tPi:n ender's Name y my signature below, I certify to each ofthe fl I am the property owner or authorized €ij I have read this application and the infor[nat I agree to comply with all applicable city and I authorize representatives of this city or COE ignature of Property Owner or Authorized Agar of construction lending provided employ any person in I of the Labor Code.J. g to building construction. for inspection purposes. Date -Cod �d license is i full force D\OS (E100,000), IN ADDITION TO THE jof the Labor Code, for th i. My workers' compensatio so as to becoMe sulpalli workers' compensation laws of California, and which this permit is issued (Section 3097, Civil Code). Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1403. ❑ I SUBMT7TEDASBESTOS NOT7FICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS N07IRCA71ON IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: FOROFRCEUSEONLY PERMIT EXPIRED 7" PERMITCANCELLED PERMITEXTENDED PERMIT FINAL CERT7FICATEOF OCCUPANCYISSUED