The URL can be used to link to this page

Home My WebLink AboutP2016-0534 - PermitsCity of Newport Beach - Building Division 111p1III IIIIIp111111111111111111p111111p1111111111PLUMBING Permit: P2016-0534 0 �G 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 6 0 5 3 4 Project No t Permit Counter Phone (949)644-3288 ti 0 n+tiruti'A'n Inspection Requests Phone (949)644-3255 Job Address: 300 ENERO Bldg. 0 Floor: Suite: Description of Work: SEWER CLEANOUT Inspector Area: 8 Code Edit 0 Legal Description: TR 5878 (L.L.84-214031) PAR 59 Owner: THE BLUFFS HOA Contractor: ROTO ROOTER Address: 2141 VISTA DEL ORO Address: 23311 MADERO STREET NEWPORT BEACH, CA 92660 MISSION VIEJO CA 92691 Phone: 949-759-1200 Phone: 714-476-3603 Con State Lic:290688 Issued Date:10/1012016 Lic Expire: 08/31/2017 Bus Lic: BT00000858 Processed By: SI J�� SN_ ` Lic Exp Date: 12/31/2016 Worker's Compensation Insurance - Carrier : ZURICH AMERICAN INS Policy No:WC0179545 Expire : 07/29/2017 FEES " ' Bathroom Fixtures Kitchen Fixtures Misc. Misc. 0 $0.00 Other $0.00 Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 Roof Drain: Trap: 0 $0.00 $0.00 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Grease 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 over 2": 0 $0.00 Sewer Alter/Repair:1 $32.00 Issuance: $0.00 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: $32.00 Plan Check Fee : $0.00 Fee Due at Permit issuance: $32.00 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 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 Iicensure 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 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). ❑ I am exempt from Iicensure 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 Iegall "I' h structure thrt 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.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION herrby affirm ; rdB: density of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business ofessions�ape, and my license is in full force and effect. / �/' �/ ., License Class License No Data ��%'�U' �G Contractor Signature/ I -��_�� NORKERS' 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 ($I00,000), IN ADDITION TO THE COST OF rOMPENSATION, CAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. nereby affirm under pe.ialty of perjury one of the following declarations: A I have and mil 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 7�I Ormance of Cie wo,k for which this permit is issued. Policy No. 5 )av, 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' compensatio n ance carrier and policy number are: Policy Number of Agent Date certify that, in 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 if I should become? he workprs—prnpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisiog5'. of te®-ic, -i6 hereby affirm underbenalty 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 ly 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 count enter t abov entified property for inspection purposes. /L11 ignature of Property Owner or Authorized Agen > �_�r/l/lam—Print Property Owner's or Authorized Agent's Name/ ??,2yr Cxlthf�"�� D ACTION DATE 1 BY DECLARATION OF COMPLIANCE WITH CODE —OF FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD [3ASBESTOS NOnFICATIONIS NOT APPLICABLE TO P POSE611lJTlON. SIGNATURE: FOR OFFICE USE ONL PERMIT EXPIRED P€RMITCANCELLED PERMITEXTENDED PERMIT FINAL %U T-Yi'+'�- CERTlFICATEOF OCCUPANCYISSUED