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HomeMy WebLinkAboutP2014-0255 - Permitsw City of Newport Beach - Building Division o 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288. r q�4iMrY4T�. Job Address: 20172 SPRUCE AVE Bldg: 1 Floor: Suite: Description of Work: PLUMB/ WATER HEATER C/O Inspector -Area: 3 Code Edit 2013 Legal Description: N TR 1506 LOT 32 Owner: TABBERT,MARK �onjractor: FAST + Address: 20172 SPRUCE AVE DWA96s 11715 NORTHC NEWPOERT BEACH CA 62660 t987 EL A 9 Phone: 36 i Con to Li 8 Issued Date:05/21/2014 Lic E re: 5 BT30036541 Processed By:&I cu- � is Exp Date: 08/31/ 14 iiiiiiiiii II PLUMBING Permit: P2014-0255 Project No : Inspection Requests Phone (949)644-3255 l®fund COMPANY OA@&W i n�p�Sion Inosurance - REEK PK 1 Carrier: TRUCK INSURANCE EXC ANGI Rol'c o:A093 1140 to w12ITI-72014 FEE Bathroom Fixtures Kitcherf. Fixtures Misc. Toilet: 0 $0.00 Kitchen $ink: 0 $0.00 Water Pipi g+ 0 Bidet 0 $0.00 Garb ageDisp; 0 r ql Urinal 0 $0.00 Bar Sink: 0 r " t pie Bath Tub: 0 $0.00 Vegetable Sink) . $ . Gas ua Outlets: 0 Shower Stall: 0 $0.00 Ice Maker. 0 $0.omorkcaka �dutlets: 0 Wash Basin: 0 $0.00 Dishwasher: 0 $0.0 Backflow up to 2": 0 Hydro -Mass Tub:0 $0.00 Lndry/Trap: 0 $0.00 Backflow over 2' Floor Sink: 0 $0.00 Regulator:;, •,,;;::(1n $0.00 i : 0 Y• Floor Drain: 0 $0.00 Lawn Spririklai" _ b 0.00 Drinking Fountain TOTAL: $49.00 Fee S is"' $0.00 0o Or i1scz $0.00 rease Trap: ��QQ �$ $15.00 Greaagneehb��iii°tlStalQQ $0.00 P -Trap: 0 $0.00 Record $0.00 Sewer $0.00 Se $0.00 , Pla $0.00 $0.00 Fee Due at Permit Issuance PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION $49.00 `0 ° ° ° a o � $0.900 ° ° o $0.0'0 )mtFee :,° $0'.00 .1no °°°° k. $0.00 $3°4.00 °©°© ° ° $49.00 `0 ° ° OWNER -BUILDER -B ILDER L for reasons indicated below b the checkmark s I have laced next to the applicable item(s) I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law fo t () o y () p pp ( ) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto 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). 0 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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-Builderwill 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 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:/lw m.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 Professions Code, and my Ice se i in full force and effect. S — / , r License Class License No -Qate `-i" Con or Signature L_ NORKERS' COMPENSATION DECLARATION A ,J�` VARNING: 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 ($100,0001, I DDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: .. I have and will..maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the serfr e of the work for which this permit is issued. Policy No. and will h(#jrltain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol i$ uran ce carrier and policy number are: .arritf- Policy Number Expiration Date 19r,petl Agent• • • Phone# :11 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 agre Al:, Tfl should 8€Sohl:subject to the workers' compensateon pr Ipna of Section 3700 of the Labor Code, I shall forthwith comply with those proylsions. .... I _ _ -a—� t 'flit. -% i 1 . .. 1 of 0affirm YAT penalty of perjury that there is a construction lenWg agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Name.... Lender's Address My signature bglplyl 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 to I enter the above -identified/ pr for inspection purposes. nature of Property Owner or Aut&ized Aoent 1__.1 A 14:2- Property Owner's or Authorized Agent's Nam� ACTION I PERNIJTEXPIRED I I I PERMITCANCELLED ER MIT EXTENDED PERMITFINAL CERTIFICATEOF OCCUPANCYISSUED FEDERAL REGULA77ONSPART 61 OF 177LE40AND AQMDRULE 1403. ❑ ISUBMITTEDASBESTOSNOTIFICATIOAITO. ❑ EPA AQMD ❑ ASBESTOS NOIIFICATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: