HomeMy WebLinkAboutP2016-0464 - Permits (3)o;%-n City of Newport Beach - Building Division II II II IIIII III II111111111111111111111111 II II
� 4 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 6 0 4 6 4
Per
Permit Counter Phone (949)644-3288
h T
Job Address: 8 CAVAILLON Bldg: 1 Floor: Suite:
Description of Work: PLUM - INSTALL WATER FILTER
Inspector Area: 6 Code Edit 2013
Legal Description: N TR 15934 LOT 33
Owner: YAO CHRISTEPHER & CONNIE
Contractor:
ECONO AIR
Address: 8 CAVAILLON
Address:
555 VANGUARD
NEWPORT COAST, CA 92657
BREA, CA 92821
Phone: Phone:
714-695-6661
Con State Lic:445220
Issued Date:08/25/2016
Lic Expire:
02/28/2018
Bus Lic:
BT30028533
Processed By:
Lic Ezp Date:
07/31/2017
PLUMBING Permit: P2016-0464
Project No :
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier : SECURITY NATIONAL INS
Policy No:SWC1089515
Expire : 10/01/2016
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:
1
$6.00
Grease Trap: 0
$0.00
$C.99
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:
0
$0.00
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 over2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
$32.00
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:
$38.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance : $38.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items)
(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).
1, as owner of the property, or my employees with wages as their sole compensation, will do U 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).
❑ 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:http://www.leginfo.c-a.gov/calaw.html.
Signature of Prnpertv Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I heresy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 Division 3 of the Business d Professions Code, and my license is in full force
and, affect.
License Class License No Dat�zf/l Contractor Signatur
NORKERS' COMPENSATION DECLARATION
`A\RNU:G: 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
:OST OF COMPENSw. ION,'JAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm a„(;erpenalty of perjury one of the following declarations:
1, have ai 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(
Y+#E+x�rance of the work for which this permit is issued. Policy No.
and wi'i n.Li ,tain 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:
Policy Number Expiration Date
of Agent Phone #
certify that, in the pppperformance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to
if I shouldbpe subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisiy
iature ofApIi
workers' compensation laws of California, and
Sell
CLARATION R'EGARI)MG"CONSTRUCTION LENDING AGENCY — "
)reby 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).
tder's Name Lender's Address
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 coury�y/to ei the above-' tified property for inspection purposes.
or
nature of Property Owner Authorized Age �/� Print Property Owner's or Authorized Agent's Nan
ACTION
DATE
BY
DECLARATION OF COMPLIANCE iMTH CODE OF
FOR OFFICE USE ONtY
FEDERAL REGULATIONS PART 61 OF TITLE 40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERANTEXTENDED
P❑ASBESTOS nONIS NOT APPLICABLE TO
ROPOSEDDEMOLITION.
PERMIT FINAL
C)Z/21 1%
M Oa
CERTIFICATE OF
SIGNATURE:
OCCUPANCYISSUED