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Home My WebLink AboutP2019-0178 - Permitst ; City of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIPLUMBING Permit: P2019-0178 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 9 0 1 7 e Project No: 0702-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 1525 KEEL DR Bldg: 1 Floor: Description of Work: PLUMB GAS TO BBQ (UNDER Suite: 42" H) Ei y , t r ° t' Inspector Area: 4 Code Edit 2016 FEES Legal Description: N TR 6152 LOT 2 Bathroom Fixtures Kitchen Fixtures Owner: BROOKS NICOLE Contractor: AQUA -LINK POOLS AND SPAS Worker's Compensation Insurance - Misc. Address: 1525 KEEL DR Address: 7040 AVENIDA ENCINAS #104-35 Carrier: MID CENTURY INS 0 $0.00 CORONA DEL MAR, CA 92625 0 CARLSBAD CA 92011 Policy No:A09472718 0 $0.00 Phone: Phone: 951-704-2257 Expire : 07/02/2019 Bidet 0 $0.00 Con State Lic:869134 0 $0.00 Water Softener: Issued Date:06/ / 19 Lic Expire: 05/31/2020 $0.00 $Woo ° Urinal Bus Lic: BT30049279 Bar Sink: 0 $0.00 Processed By L' xpDate: 12/31/2019 Grease Interceptor:0 $0.00 Bath Tub: 0 $0.00 Vegetable Sink: 0 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. ° 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 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 $Woo ° 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: 1 $7.00 P -Trap: 0 $0.00 Record Mgmt Fee:° 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 tot". 0 $0.00 Sewer: 0 $0.00 Plan Check: a90.Q0 °oaa°° Hydro -Mass Tub:0 $0.00 LndryfTrap: 0 $0.00 Backflow over 2'". 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: °$39.00 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: $42.00 Plan Check Fee `. $0.00 Fee Due at Permit Issuance: $42.00 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. 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). ❑ 1, 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). ❑ 1, 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 ap ly 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). 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 Iegall 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 under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sec jjon 70QGs 0) Rf Division 3 of the Business and Prof sio Co nd my license is in full force and effect (/�� G t � License Class License No D to _.. CO ntr Ig lure WORKERS' CQKP�ENSATION DECLARATION NARNING: FAILURE TO S_FF��OURS WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CI FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($'100,000), IN ADDITION TO THE COST OF.COMPENSA�S00. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. :ltaiinyaffirm 44*f Penalty of perjury one of the following declarations: :11 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 IN PRIgpSnce of the work for which this permit is issued. Policy No. vg and w9Lglalptain 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' compensatio asurar6ce carrier and policy number are: `t '+ e-7 'sarrior•T�• `� C -q d9Policy Number A C) 7 3. -7 l Q Expiration Date 4"& of Agent .n: G 1tio Cvb Iv -,r ^.t'J'-OV Phone# CilL GICIO T t8% that, inthe performance of the work for which this tis Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre Nat, if I Should *' he subject to the s' compensation p sof Section 3700 of the Labor Code, I shall forthwith comply with those p ns. ...... Cyarv/f 3icnatureof ADa1M4R�r ---/ 1 Dace---\ :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. 1 agree to comply with all applicable city and county orqQnces and state laws relating to building construction. I authorize representatives oft this county to an eve- 'led property for inspection purposes. ��""'' nature of Prooertv Owner or. horized Aqent Print Propertv Owner's or Authorized Aqent's Name\S'rw )JA' Gr9HIoL'1 Irl $I�-:37 I F�tliit l]tL+/7FiU9Rf.7.� s I PERMITEXTENDED I I I ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ASBESTOS NO'RRCA ROWS NOT APPLICABLE TO PROPOSED DEMOLITION. OCCUPANCYISSUED I I II SIGNATURE