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Home My WebLink AboutP2017-0244 - Permits.,,City of Ngwppfc Oeach - Building Division IIIIIIIIIIIIIIilllllllllllllllllllllllllllllllllll PLUMBING Permit: P2017-0244 +� 'E 100 Civic Cgntor Nejp�t Beach, CA 92660 P 2 0 1 7 0 2 4 4 Project No oPe"ib CorrftePPlfone 4949�a44-3288 ca y m Inspection Requests Phone(949)644-3255 e e ++• `e' eee +e• - Job Address: 2134 VISTA ENTRADA Bldg: 1 Floor: Suite: Description of Work: PLMB -SEWER CLEAN -OUT Inspector Area: 8 C it-M Legal Description: N TR 8682 L 1 / n Date: (` G- Owner: NORTH JAMES S o c o . OROOTER-----'--.--- �f api WfY�?Compensation Insuranc - Address: 2134 VISTA ENT A Address: 1183 N KRAEMER PL Carr' ,(�}}��,��I��r}� AMERICAN NS p� NEWPORT BEACH CA Ali? A 8 ❑ 80% li ld.4AIII0G7619aal till t x, Phone: hon Expire : 07/29/2017 ° on t0 Whom: Issued Date:05/31/201 is Expr . Bus Lic: BT00000858 Processed By: is EMM/PIRED E FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other I Toilet: 0 $0.00 Kit nk: 0 $0.00 ater Pi mg: 0 Roof Drain: $ 00 (' $0.00 Bidet 0 $0.00 Ga age is��$gp�� 0 o ener. 0goo a $0.00 Urinal 0 $0.00 Be 0" ter: 0 L p O �:06v Bath Tub: 0 $0.00 Vegetable Sink/1/� 0 s u to 4 outlets: 0 $0.0 P T p $0.00 Record'.M mt Fee: $0.00 Shower Stall: 0 $0.00 Ice Maker: ` OOr O�gdrt2 Gas over 4 outlets: 0 $0.00 ��os'e' st$rteU) Investigation: $0.00 Wash Basin: 0 $0.00 i hwasher: 0 $0.00 Backflow up to 2": 0 $0.00 Sewer: 0 $0.00 Plan Check: $0.00 Hydro -Mass Tub:0 $0.00 te2p- 0 0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:l $33.00 Issuance: $33.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer A an on: 0 upplemental Fee: $0.00 Floor Drain: 0 $0.00 1 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 AdditiloedbitiatS$0. TOTA : an ssuance: $66.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. OWNER -BUILDER DECLARATION • + • . . ' I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(sla iayGQlau• *d+nert to tQe applioable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance,%Iso mquilles.the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fona permit subjects the applicant to a civil penalty of not more than five hundred dollars ❑ 1, as owner of the propertytzdr employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not+nte$ded or oNered for sale.(5ectiond044, Business and Professions C?o he C J?nn p State License Law does not apply to an owner of property who, through elggjq � sonal effort, fiuiltI br imp's-ws1l;8 propert)M pioviJed that the improvements are not interned offers or sae. year of c I t r-Builder will have the burden of proving that it wSs not built or improved for the purpose of sale). f-� o �� I —I ❑ I, as owner of the property, am clus ting w' Aence t to n ion 7044,-ttusl�%.arPQS1il; Q& de `Tlie Contractors' State License Law does not apply to an owner of propertK�who wilds r impro they an wc t lects wit s Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from Iicensdm u er th Contrac s' St is fo I as By my signature below I ackno sled a tha my per re ich us n nu+ a i orapletieR-Gk#eamprovements covered by this permit, I cannot Iegall) sell a structure that 1 have bbilt 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 on re this a Iication is submitted or at the following Web site:htt://www.leginfo.ca.gov/calaw.htmi. Signature of Property Ownergr Au oriz gen Date LICE ED TO CL TI In U I hereby affirm under penalty;af p ury t I a li sed der, ro o hapter ( ci with S do 00) of Division 3 of the Business an rofessions Code, and my license is in full force and effect. License Class License No Date."/ Contractor Signature - WORKERS' COMPENSATION ECLARATION WARNING: FAILURE TO SECURE WORKERr COM N C GE IS UNLAWFUL, ANDS ALL SUBJECT AN EMPLOY IMI Er(ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS P OVIDE FOR I SE 0 0 I arhAND ATTORNE S FEESr+! I hereby affirm under penalty of perj ry on of th foe do t n : y�. J LJ i card .l I have and will maintain a carte cate of consent t `;P,II -{n 'rg if 1y r rf compensation, issued by the Di ctor of Ind stria Relation s provided for by Section 3700 of the Labor Code, for thI )eerrformance of the work for which t s permit is issued. mid. ttfog` r`�id no wortC $�al t 8) 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 I surance carrier and policy numbs rNote: Carrier o Icy Number xp1 a ate Name of Agent P�Qj#� ❑1 certify that, in the performance the work for which this ermit is issued I shall not employ any person in anyma�nne�r so as to become subject to the workers' compensation laws of California, and agree that. if I should become-enbiechtatha wor era compeosa 10 p ovlsl I n nbfiP�l IY1ti 119�mt>nn�se FPd+YfS'faris:' ' nature of Applicant ,-v-- CLARATION REGAR ON CSTRUCTION LENDING AGENCY ;reby 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). 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 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. 1 authorize representatives of this city or coun o en a above -identified property for inspection purposes. 71 is,,r— ACTION DATE BY DECLARATION OF COMPLIANCE MTNCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 61 OF IIILE40AND AQMD RULE 7403. PERMIT EXPIRED �- / ❑ I SUBMITTEDASBESTOS NOTIFICATION TOr ❑ EPA ❑ AQMD PERMITCANCEUED PERA41TEXTENDED ❑ ASBESTOS NOTIFICATIONIS NOTAPPLiCABLETO PROPOSED DEMOLITION. SIGNATURE: PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED