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HomeMy WebLinkAboutP2021-0119 - Permits (2)City of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111111111 ati 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 1 1 9 Permit Counter Phone (949)644-3288 $`�clrvrY�� Job Address: 218 WHITE CAP LN Bldg: 1 Floor: Suite: Description of Work: PLUMB/CHANGE OUT (E) WATER HEATER Inspector Area: 6 Code Edit 2019 Legal Description: Owner: Contractor: SCOTT PLUMBING INC Address: Address: 10765 LAUREL AVE Policy No:WSD502224508 FEES SANTA FE SPRINGS, CA 90670 Phone: Phone: 562-944-9793 Con State Lic:813415 Issued Date:04/12/2021 Lie Expire: 10/31/2022 n Bus Lie: BT30049015 Processed By: \_]Yv.4� Lie Exp Date: 11/30/2021 PLUMBING Permit: P2021-0119 Project No: Inspection Requests Phone (949)644-3255 IF, 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. oGG •so iGG aoc ® e r u m e o c 0 oGo o G bB B C O 4 rom O• f U U n V v) 9 GCC U G 9 G08 U< UEG O 6 GU U(r f4D Worker's Compensation Insurance - Carrier : INS OF THE WEST ,•' Policy No:WSD502224508 FEES Expire : 11/01/2021 Bathroom Fixtures 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. oGG •so iGG aoc ® e r u m e o c 0 oGo o G bB B C O 4 rom O• f U U n V v) 9 GCC U G 9 G08 U< UEG O 6 GU U(r f4D 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 $0.00 Urinal 0 $0.00 Bar Sink: 0 $0.00 Water Heater: 1 $31.00 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:0 $0.00 Lndry/Trap: 0 $0.00 Backflow overt": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $37.00 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: $66.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $68.00 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. oGG •so iGG aoc ® e r u m e o c 0 oGo o G bB B C O 4 rom O• f U U n V v) 9 GCC U G 9 G08 U< UEG O 6 GU U(r f4D ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 (_) 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 -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 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.htmi. 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 license is in full force and effect. ��AA License Class License No Dat w Contractor Signature, ✓O NORKERS' COMPENSATION DECLARATION 1 11 NARNING: 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 070B 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 'ormance of the work for which this permit is issued. Policy No. and willrcyeiMain workers' carrier arrr voliLLv number of Agent as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Date 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 if I should become s(u'bbj/set to the works ' compensation prop'sions of Section 3700 of the Labor Code, I shall forthwith comply with those proxf'siolns. f IatureofApplicant ._`�_ 4 fD Deter z// 41dl CLARATION REGARC bItONSTRUCTION LENDING AGENCY Breby 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. 1 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 coun�(to nter the aagRve-identified pr arty for inspection purposes. nature of Prooertv Owner or Authorized Anent X Print Prooertv Owner's or Authorized ADent's Name Z M0.Pl C SGD1 AC77ON PERMITEXPIRED PERMIT CANCELLED PERMITEXTENDED PERMIT FINAL CER77FICATEOF OCCUPANCYISSUED U7 fd��t37 0 I SIJCIMQT;DAS13ESiOSNLLf nCATfON rO. 0 EPA 0 AQMD ASSEST 077 CA710M IS NOT APPLICABLE TO PROPOSED I61N•'. ••• s�� �•• SIGNATURE: : •� •• : :� ••• •• •• • • ••• ••