The URL can be used to link to this page

Home My WebLink AboutP2017-0165 - PermitsCity of Newport Beach - Building Division "P2017--0165" 100 Civic Center Drive, Newport Beach CA 92660 Per ti r Permit Counter Phone (949)644-3288 v n s aLtitM� Job Address: 41 HARTFORD DR Bldg: 1 Floor: Suite: Description of Work: PLUM -CHANGE OUT WATER HEATER (SAME LOCATION) InspectorArea: Code Edit 2016 Legal Descriptio : TR 12164 LOT 2 UNIT 21 OF PROJECT LOCATED ON AP 442-291-39 TOGETHER Owner: CLARK DAVID Contractor: ORANGE INSTALLERS Address: 41 HARFORD DR Address: 905 E CHALYNN AVE NEWPORT BEACH CA 92660 ORANGE CA 92866 Phone: Phone: 714-532-4857 Con State Lic:511971 Issued Date:04/24/2017 Lic Expire: 06/30/2017 Bus Lic: BT30056924 Processed By: Lic Exp Date: 10/31/2017 PLUMBING Permit: P2017-0165 Project No Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier: SECURITY NATL INS CO Policy No:SWC1093581 Expire : 01/07/2018 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 1 $15.00 -Grease tnterceptor: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 Lndryi7rap: 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: $48.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $48.00 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. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale 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). ❑ 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 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.ca.gov/calaw.html. Signature of Pnperty Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm and=r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professio C de and my license is in full force and effect. / '_icense Class License No Date,6 Z� - i Contractor Signatures — WORKERS' COMPENSATION DECLARATION 'ARN'N .: FAILURE .0 SECJRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE COST OF COMPEN^f T-ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 hereby affirm and=r penalty of perjury one of the following declarations: . have and wil, 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 ;ormance of Ike wort: for which this permit is issued. Policy No. hsv; 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' compensatiol " rzaoce carritr and policy number are: ie of Agent certify that, in the performance of the work . if I should become subJO'ct to the yrorkers' Policy Number this permit is issued, I shall not employ any person in any manner so as to become subject to the wor rs' compensation laws of California, and �tio� visions of -tion 3700 of the Labor Code, I shall forthwith comply with those provisions. r-i ` tea_ r 7 lignature of Applicant — I v v �- - )ECLARATION REG DING CONSTRUCTION LENDI ENCY hereby 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). 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 coun ordinances and state laws relating to building construction. I authorize representatives of this city or count enter t ov I tified pro erty for inspection purposes. r 1/0 (-4 o e Cr Signature of Property Owner or Authorized Age Print Property Owner's or Authorized Agent's Nam ACTION DATE BY DECLARATION OF COMPLIANCE IMTH CODE OF FOR OFFIL FEDERAL REGULATIONS PART 61 OF TIRE40 AND PERMFTEXPIRED ❑ 1SUBMITTED ASBESTOS NOTIFICATION TO: PERMITCANCELLED ❑ EPA PERMITEXTENDED [3 AOMD ❑ ASBESTOS NOTIHCATIONtS NOT APPLICABLE TO PE fvl f FINAL 051 / j 61 tcw, PROPOSED DEMOLITION. CERTIFICATEOF 11n,7• SIGNATURE: OCCUPANCYfSSUED ONLY Z�(-lJ