HomeMy WebLinkAboutP2021-0219 - Permits�w •rF� City of Newport Beach - Building Division 'P2021-0219"
100 Civic Center Drive, Newport Beach, CA 92660
-," Permit Counter Phone (949)644-3288
NOHNSPECTUOR
Job Address: 880 IRVINE AVE Bldg: 1 Floor: Suite:
Description of Work: MFR -"BLDG R" CHANGE OUT (1) WATER HEATERS
Inspector Area: 3 Code Edit 2019
Legal Description: P BK 15 PG 36 PAR 1
Owner: UDR NEWPORT BEACH NORTH L
Contractor:
Compensation Insurance -
Address: PO BOX 06408
Address:
2510 N GRAND STE 110
CHICAGO, IL
SANTA ANA CA 92705
Phone: 0
Phone:
714-315-5607
Con State Lic:556812
Issued Date:
Lic Expire:
02/28/2023
Bus Lic:
BT30073028
Processed By:
Lic Exp Date:
09/30/2021
PLUMBING Permit: P2021-0219
Project No :
Inspection Requests Phone (949)644-3255
SERVICE FIRST smmmmWorker's
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Carrier: STATE NATL INS CO omo
Policy No:AMX0820021004 mGm s
Expire : 10/01/2021
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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.
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FEES
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Bathroom Fixtures
Kitchen Fixtures
Misc.
Misc.
Other
m
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
$62.00
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 over 2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
$38.00
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:
$100.00
Plan Check Fee :
$100.00
Fee Due at Permit Issuance: $0.00
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 L) all of or L 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).
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 b this permit, I cannot Iegall)
sell a structurEjl" 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 044 of the Business and
Professions•C`q(7g• IS available upon request when this application is submitted or at the following Web site:http:L/www.leginfo.ca.gov/calaw.html.
iigra•tore of Property Owner or Authorized Agent Date
• LICENSED CONTRACTOR'S DECLARATION
Lhereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing Section 7000) of Division 3 of the Business and Pr fes s (1, and my license is in full force
%i j gffect.
Llcenje Class +`— • • License No Date 6slavl Contractor Signature
tSVCMKl5RS' COIVIPE•NSATION DECLARATION
INN: FAILURI�%V'byRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS/1MD DOLLARS ($100,000), IN ADDITION TO THE
IT OF COMPENSIOTION•DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. U//
eby affirm under penalty of perjury one of the following declarations:
1 ha$e and y.All ipbaitain 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 thI
f_ormance of ttfework for which this permit is issued. Policy No.
and vylt pyaAain 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'
carrier and pGlicy number are:
me of Agent
I certify that, in the performance of
It. if I should become su8iect to the
Policy Number
Date
ermit is issued, I shall not employ any person in any manner so as to become subject to
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisj9
',ignature of Applicant L,/
D
IECLARATION REGA NG C TRILIOCTION LWDING AGENCY
hereby affirm under pena perjury that the construction lending
agency for the performance of the work for which this permit is issued
ender's Name
Lender's Address
Iy my signature below, I certify to each of the fo owing:
I am the property owner or authorized to act on the prooer'I
have read this application and the information I have pI
agree to comply with all applicable city and county Orr
s relating to building construction.
I authorize representatives of this city or county ente
property for inspection purposes.
ignature of Property Owner or Authorized Agent
Print Property Owner's or Authorized Agent's Nam
ACTION DATE
BY
DECLARATION OF COMPLIANCE 4YITN CODE OF
FEDERAL REGULATIONS PART 61 OF T17LE40 AND
AQMD RULE 9403.
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS N077FICATION'TO:.
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS U07IRCA77ON IS NOT APPLICABLE TO
PERMIT FINAL }. (AR
PROPOSED DEMOU TION.
CERTIFICATEOF I'
OCCUPANCYISSUED
SIGNATURE:
workers' compensation laws of California, and
Code).
FOR OFFICE USE