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Home My WebLink AboutP2019-0163 - Permitsg.-Aly City of Newport Beach - Building Division IIIIIIII IIIIIIII IIIIII II IIIIII IIIIIIII II PLUMBING Permit: P2O19-0163 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 9 0 1 6 3 Project No Permit Counter Phone (949)644-3288 L)P114� Inspection Requests Phone (949)644-3255 Job Address: 416 VISTA GRANDE Bldg: 1 Floor: Suite: Description of Work: PLUM - SEWER CLEAN OUT - Inspector Area: 8 Code Edit 2016 Legal Description: TR 6230 (L.L.84-214033) PAR 8 Owner: THE BLUFFS HOA Contractor: ROTO ROOTER SERV Workers Compensation Insurance - Address: 2141 VISTA DEL ORO Address: 23311 MADERO Carrier: FEDERAL INS NEWPORT BEACH, CA 92660 MISSION VIEJO CA 92691 Policy No:54309480 Phone: Phone: 949-380-4161 Expire : 0810112019 Con State Lie:1016021 Issued Date:05/3012019 Lie Expire: 07131/2020 Bus Lie: BT30057895 ^ ^ Processed By: Lie Exp Date: 01/31/2020 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 $O.CC 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:O $0.00 Lndry[Trap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:l $35.00 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: $70.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $70.00 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' 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 Cade: 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 l 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). ❑ 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 urder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ection 7000) of Division 3 of the Business and Prof ssions Code, and my license is in full force / and qqect. License Class _ _ License No Date 5 Contractor Signature i URKORS' 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 COET OF 90MPENSf.TIPN, ofMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I I-.erehy affirm under penalty of perjury one of the following declarations: 0 1 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 pipe <r,riaance of the work for which this permit is issued. Policy No. 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' carrier andpolcy number are: Policy Number Expiration Date is of Agent I certify that, in the performaDco 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 agre that, if I should become subj workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant � Date (� 0 DECLARATION REGARDI ONSTRUCTION LENDING AGENCY I 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). Lender's Name Lender's Address By 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�rand state laws relating to building construction. I authorize representatives of this city or county t enter th ve-identified property for inspection purposes. GU/ 4ef4ef Signature of Property Owner or AuthorizedAge Pdnt Property Owner's or Authorized Agent's Name ACRON DATE BY DECLARATION OF COMPLIANCE MTH COEOF FOR OFFICE USE ONLY FEDERAL PEGULATIONSPART 61 OFTITLE40AND AQMO RULE 1403. PERMITEXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED PROPOSED EMOLI pry ilONIS NOT APPLICABLETO PERMITFINAL 03-/3)/(1 li(M c OLc CERTIFICATEOF SIGNATURE. OCCUPANCYISSUED