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Home My WebLink AboutP2017-0532 - PermitsCity of Newport Beach - Building Division *P2017-0532" 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 U144'0�1 PLUMBING Permit: P2017-0532 Project No : 2823-2015 Inspection Requests Phone (949)644-3255 Job Address: 4615 BRIGHTON RD Bldg: 1 Floor: Suite: Description of Work: PLUMB/GAS LINE TO FIREPIT Inspector Area: 5 Code Edit 2016 Legal Description: N TR 3357 LOT 147 Owner: SHILOH LLC Contractor: DYER J C COMPANY INC Worker's Compensation Insurance - Address: 4615 BRIGHTON RD Address: 1540 S COAST HWY #205 Carrier: EVERST NATIONAL �. CORONA DEL MAR, CA 92625 LAGUNA BEACH CA 92651 Policy No:7600012640 Phone: 949-419-5266 Phone: 714-809-3258 Expire : 02/02/2018 r' Con State Lic:586784 ' Issued Date:12/04/2017 Lic Expire: 0313112018 Bus Lic: ST98042174 �\ Processed By: \ `)f Y r� Lic Exp Date: 02/28/2018 6 _ Ak ? 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 $6.00 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 $0,01 Sewer: 0 $0.00 Plan Check: $0,00 Hydro -Mass Tub:0 $0.00 Lndryrrrap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $33.00 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: $39.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $39.00 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. 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 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-Builderwill have the burden of proving that it was not built or improved for the purpose of sale). ❑ 1, 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 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:hftp://www.leginfo.ca.gov/calaw.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 Section 7000) of Division 3 of the Business and ProfJCode, and my ense is in full force and effect. 7 License Class License No — Date A �! / 2 - / ' /7 Contractor Signature � COMPENSATION DECLARATION IARNING: 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 ;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 th, e ormance of the work for which this permit is issued. Policy No. I have a intain 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' compensatior isurance c4TndTolicy number a )arrier 1R?n I NI(a�', Expiration Date Of certify that, n the performance of the work forwhich 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 sybjectlg_tb2_Mec ws:compensaiieR-o[ovisio of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applic�n �� "�� Da DECLARATION RE AR ING CONS UCTION LENDING AGENCY hereby affirm undef penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or county�to�nte he-atrov -ide tified p rty for inspection purposes. ignature of Property Owner or Authorized Agent i� - ti Print Property Owner's or Authorized Agent's Name 3097, Civil Code). AC77ON GATE BY DECLARATION OF COMPLJANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL ✓:EGULATONS PART bi DF T17LE 40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I S(IBMf,TEUASBt-Si05 NU71,:IC4Ti{IN TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIRCA770NIS NOT APPLICABLE TO PROPOSE D ilcidOLTION. PERMITFINAL CERTIFICATEOF SIGNATI IRF: OCCUPANCYISSUED