HomeMy WebLinkAboutP2015-0129 - Permitsw$w City of Newport Beach - Building Division 111111III IIIII IIIII IIpI111111111111111111111111111111
o� 6 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 5 0 1 2 9
r •`, Permit Counter Phone (949)644-3288
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Job Address:' 1409 HIGH BLUFF DR Bldg: 1 Floor: Suite:
Description of Work: PLUMB/GAS TO BBQ (<4211), FIREPIT & FIREPLACE
Inspector Area: 3 Code Edit 2013
Legal Description: N TR 15243 LOT 18
Owner: JUNKINS MITCHELL
Contractor:
PROMONTORY POOLS INC
Address: 1409 HIGH BLUFF DR
Address:
17401 IRVINE BLVD STE B
NEWPORT BEACH, CA 92660
TUSTIN CA 92780
Phone:
Phone:
714-993-0554
Con State Lic:404194
Issued Date:03/16/2015
Lic Expire:
03/31/2015
Bus Lic:
BT30043247
Processed By: o
Lic Exp Date:
05/31/2015
S
PLUMBING Permit: P2015-0129
Project No
1
i
Inspection Requests Phone (949)644-3264
Worker's Compensation Insurance -
Carrier: STATE FUND -
Policy No:0699054
Expire: 04/01/2015 -
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 9
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 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:
$0.6o
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
Backilow, up to 2":
0
$0.00
Sewer: 0
$0.00
Plan Check:
$0.60
Hydro -Mass Tub:0
$0.00
Lndry/Trap:
0
$0.00
Backftow over 2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
$35.00
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:
$50.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance: $50.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate 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 itwas 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 legal)
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 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 Se on 70 ) of Division 3 of the Business and Pr essi , and Icense is in full force
and effect.
License Class License No Date %6 Contractor Signature
ORKERS' 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I 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 th(
performance of the work for which this permit is issued. Policy No.
I have 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' compensatior
insurance car(l-eraiho policy numbedare: _
Number
ie of Agent
certify that, in the p,
, if I should become
Date
Led, I shall not employ any person in any manner so as to become subject to the
of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ereby affirm Ljnder penaly 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 6proy own be alf.
I have read ihis application and the information ide Is co ct.
I agree to comply with all applicable city and coes a stat s relating to building construction.
1 authorize representatives of this city or county ad a-ide Pfe property for inspection purposes.
nature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Name
Civil Code).
laws of Califomia, and
/f
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
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PERMIT CANCELLED
PERMIT D(TFNDED
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