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Home My WebLink AboutP2014-0417 - PermitsCity of Newport Beach - Building Division 111p111111111p111111111111111111p11111111111111p 11 o� 100 Civic Center Drive. Newport Beach, CA 92660 P 2 0 1 4 0 4 1 7 Permit Counter Phone (949)644-3288 V PLUMBING Permit: P2014-0417 Project No Inspection Requests Phone (949)644-3255 Job Address: 12 CORSICA DR Bldg: 1 Floor: Suite: Description of Work: PLUM -REROUTE COLD WATER LINE FROM GAR #12, THRU GAR #8 AND #6 TO BEHIND TOILET USING 3/4" PEX PIPE Inspector Area: 4 Code Edit 2013 Legal Description: TR 12306 LOT 2 UNIT 11 OF PROJECT LOCATED ON AP 442-053-15 TOGETHER Owner: NEWPORT NORTH PROP MGMT Contractor: PROSERV PLUM & DRAIN Worker's Compensation Insurance - Address: 23726 BIRTCHER DR Address: 3012 ENTERPRISE ST #F Carrier: LIBERTY INS CORP LAKE FOREST CA 92630 COSTA MESA CA 92626 Policy No:WC7631508631012 Phone: Phone: 714-540-8400 Expire : 10/01/2014 Con State Lic:798615 Issued Date:08/19/2014 Lic Expire: 08/31/2015 Bus Lic: BT01100443 Processed By: Lic Exp Date: 08/31/2014 FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 1 $6.00 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 Hydro -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: $40.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $40.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -BUILDER 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). ❑ 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 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 Prof sions Code„Pn�i my license is in full force and effect. �.icense Class - _ _ License No Date �� Contractor Signature T Lrl NORYERS' COMPENSATION DECLARATION YARNIV^,: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (a100,000), IN ADDITION TO THE COST OF COMPENSATION, CAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. hereby affirm under pEialty of perjury one of the following declarations: 7 ' 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 the ormance of the work for which this permit is issued. Policy No. h31c 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' compensation surance carrier qnd 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 ag if I should become subject toothy workers' coglpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of CLARATION REGARDYIG CONSTIR/JCTION LENDING AGENCY ' veby 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). 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. 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 toeprt�h !b�!e-identified property for inspection purposes. nature of Property Owner or Authorized Agent ,/" vrwJ " Print Property Owner's or Authorized Agent's Name l UYIL 1 n Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OFTITLE40 AND AQMD RULE 1403. PERMIT IXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO., ❑ EPA PERMIT CANCELLED ❑ AQMD PERMITEXTENDED ASBESTOS PROPOSED DEMOLITION.TION IS NOT APPLICABLE TO PERMIT FINAL /— C€RTIFICATEOF SIGNATURE: OCCUPANCYISSUED