HomeMy WebLinkAboutP2014-0423 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII II
04 O 100 Civic Center Drive, Newport Beach, CA 92660 P 2 9 1 4 9 4 2 3
Permit Counter Phone (949)644-3288
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Job Address: 35 CORSICA DR Bldg: 1 Floor: Suite:
Description of Work: PLUMB/REMOVE-RPLACE (E) WATERLINE SERVICE METER RO MAIN
35, 37, 39 & 41 CORSICA DR
Inspector Area: 4 Code Edit 2013
Legal Description: TR 12306 LOT 2 UNIT 23 OF PROJECT LOCATED ON AP 442-053-15
TOGETHER
Owner: NEWPORT NORTH TOWN HOMES Contractor:
PROSERV PLUM & DRAIN
Address: 23726 BIRTCHER DR Address:
3012 ENTERPRISE ST #F
LAKE FOREST CA 92630
COSTA MESA CA 92626
Phone: Phone:
714-540-8400
Con State Lic:798615
Issued Date:08/21/2014
Lic Expire:
08/3112015
Bus Lic:
BT01100443
Processed By: CA0 Lic Exp Date:
08/31/2014
PLUMBING Permit: P2014-0423
Project No :
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier: LIBERTY INS CORP
Policy No:WC763150863101211
Expire : 10/01/2014
s"
FEES
Bathroom Fixtures
Kitchen Fixtures
Misc.
Misc.
Other
Toilet:
0
$0.00
Kitchen Sink:
0
$0.00
Water Piping:
4
$24.00
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:
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
Hydra -Mass Tub:0
$0.00
Lndry/Trap:
0
$0.00
Backflow over 2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
$34.00
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
TOTAL:
$58.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance : $58.00
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 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 L) 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).
❑ 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 legally
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 Prgfessions Cod and my license is in full force
and effect. 1
License Class License No Date J Z/
� Contractor Signaturee
WORKERS' COMPENSATION DECLARATION \
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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 thr
perf9rmance of the work for which this permit is issued. Policy No.
have and will aintain workers' compgnsation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
rance carrier an olicy number are:
Date
to of Agent 1 ,_XJ V , V %LJ —Ci rnone n
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 subject to the,Iworkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,I
of
CLARATION REGARDING 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
Ider'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.
1 agree to comply with all applicable city and county ordi ances and state laws relating to building construction.
I authorize representatives of this city or count' to gpt�he abgXe-ipentified property for inspection purposes.
of Property Owner or Authorized
Owner's or Authorized
Civil Code).
)11
ACTION
DATE
BY
DECLARATION OFCOMPLIANCE IMTHCODE OF
FOROFHCEUSEt7NLY
FEDERAL REGULATIONS PART 61 CF TnLE40AND
AWWD RILE 140.,.
PERMIT EXPIRED
❑ ISGSMITFEbAS,3FSTOSIJOr7FrCATIONTO:
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❑ ASFESTOSNO71FICAPONISNOTAPPLICABLETO
PROFOSECD MJETION.
PERMITCANCELLED
PERMIT EXTENDED
PFRMITFINAL
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CERTIFIC4TEOF
SIGUA, URE:
OCCUPANCYISSUED