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Home My WebLink AboutP2019-0108 - Permitswt City of Newport Beach - Building Division o 100 Civic Center Drive, Newport Beach, CA 92660 i Permit Counter Phone (949)644-3288 v # '-.nom&.Mr6tt'�s' II III ILII 0IIII ILII /III TVI VIII ILII 0IIII SII II Job Address: 122 MARINE AVE Bldg:1 Floor: Suite: Description of Work: PLUMB WATER HEATER REPLACEMENT Inspector Area: 2 Code Edit 2016 Misc. Legal Description: BALBOA ISLAND SEC 4 BLK 2 LOT 19 Toilet: Owner: MORCOS ELLIS Contractor: PAYLESS WATER HEATERS Address: 122 MARINE AVE - Address: 27919 SMYTH DR NEWPORT BEACH, CA 92662 VALENCIA CA 91355 Phone: Phone: 661-775-2944 Con State Lic:836216 $0.00 Issued Date:04/10/2019 Lic Expire: 08/31/2020 Bus Lic: BT30041725 Processe y: Lic Exp Date: 12/11/2019 Bathroom Fixtures Kitchen Fixtures rar 8 Misc. Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 Urinal 0 $0.00 Bar Sink: 0 $0.00 Water Heater: 1 Bath Tub: 0 $0.00 Vegetable Sink: 0 $0.00 Gas up to 4 outlets: 0 Shower Stall: 0 $0.00 Ice Maker: 0 $0.00 Gas over 4 outlets: 0 Wash Basin: 0 $0.00 Dishwasher: 0 $0.00 Backflow up to 2": 0 Hydro -Mass Tub:0 $0.00 Lndry/Trap: 0 $0.00 Backflow over t": 0 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 TOTAL: $51.00 Plan Check Fee : PLUMBING Permit: P2019-0108 Project No: Inspection Requests Phone (949)644-3255 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. rar 8 u Worker's Compensation Insurance - Carrier : EMPLOYEE SVC GROUP Policy No:C65197844 Expire : 08/01/2019 ° o °ceo ° ¢meoPc u Misc. Other $0.00 Roof Drain: 0 $0.00 $0.00 Grease Trap: 0 $0.00 $16.00 Greaselnterceptor:0 $0.00 $0.00 P -Trap: 0 $0.00 Record Mgmt Fee: $0.00 o $0.00 Sewer Investigation: , $0.i10 ocy ° $0.00 Sewer: 0 $0.00 Plan Check: $0.00 Sewer Alter/Repair:0 $0.00 Issuance: °$35.00 ° $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: °°%0.60 $0.00 Additional Fee : $0.00 $0.00 Fee Due at Permit Issuance : $51.00 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 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 (_) 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). 0 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 Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION thereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (co men Ing with Sectio 7000) f Division 3 of the B smess and Professions Code, and my license is in full force and effect. /1 ^^zz �1 / // License Class C �J License No 36 �l(o to / CogtfaSt natur NORKERS' COMPENSATION DECLARATION YARNING: FAILURE TQQ$$ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO UNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE :OST OF COMPENSpfi101t,L@MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. r re ft offirm un8@r pt3nalty of perjury one of the following declarations: .. �. I hale and wil�.�ai.ntain 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 otfyrrR%nce of the work for which this permit is issued. Policy No. I have and wil�mainjain 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 B carrieT�Rd pylic erare-/�� p arner •w r/-�' Policy Number .� Expiration Date l /_ J•s•• ame o(Agent• • �� Phone # Q — ... .74fy that, in Ehe 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 workef s' compensation laws of California, and ogre hat, if ).should becom jec thg workers' compensation 0roviWns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �, / _ Eby affirm under+penalty erjury-that there is -a construction lending agen for the performance of the work for which this permi s issued (Section 3097, Civil Code). ter's Name Lender's Address iy 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 applicatiomand the information I have provided is correct. I agree to comply with all applic a city an my ordinances and state laws relating to building construction. I authorize representatives of this ill county t _ ater the-above-identifieoro9pjorty for inspection purposes. AC7701V DATE BY OEC ON OF COMPLIANCE TN CODEDF FEDERA EGUL ATIOMI PART t71 f7LE40ANd AQMD RULE 1403. 1 SUBMITTED ASBESTOS N071FICATION TO. - ❑ EPA ❑ AQMD ❑ ASBESTOS M077RCA710NIS NOT APPLLCABLE TO PROPOSED DEMOLITION. SIGNATURE: _— - FOR 4 FlC {J EDN, PERMITEXPIR€D I PERMITCANCELLED PERM/TTEXTEND€D PERMIT FINAL CERTIFICATEOF OCCOPANCYISSUED