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Home My WebLink AboutP2016-0394 - Permits (2)rr City of Newport Beach - Building Division 111p111111111p11111111111111111111111111111111111111 a '+� 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 6 0 3 9 4 Permit Counter Phone (949)644-3288 .rs Job Address: 2143 VISTA ENTRADA Bldg: 1 Floor: Suite: Description of Work: PLUMB -SEWER CLEANOUT Inspector Area: 8 Code Edit 2013 Legal Description: TR 5878 (L.L.84-214031) PAR 33 Owner: THE BLUFFS HOA Contractor: ROTO ROOTER Address: 2141 VISTA DEL ORO Address: 23311 MADERO STREET NEWPORT BEACH CA 92660 MISSION VIEJO CA 92691 Phone: Phone: 714-476-3603 Con State Lic:290688 Issued Date:07/20/2016 Lie Expire: 08/31/2017 Bus Lie: BT00000858 Processed By:- Lie Exp Date: 12/31/2016 PLUMBING Permit: P2016-0394 Project No : Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier : ZURICH AMERICAN INS Policy No:WC017954500 Expire-9W43120T9- 02::>-h•I 7r FEES ° Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other ... . .....i 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 $0.00 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: 0 $0.00 P-Trap: 0 $0.00 Record Mgmt Fee: o $®.DU Shower Stall: 0 $0.00 Ice Maker: 0 $0.00 Gas over 4 outlets: 0 $0.00 Sewer Investigation: Aill-DO o 0 Wash Basin: 0 $0.00 Dishwasher: 0 $0.00 Backf ow up to 2": 0 $0.00 Sewer: 0 $0.00 Plan Check: 0.%go Hydro -Mass Tub:0 $0.00 Lndry/Trap: 0 $0.00 Backftow over 2": 0 $0.00 Sewer Alter/Repair:l $32.00 Issuance: $37.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: W000° ° Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 Additional Fee: $0.00 `..... ° TOTAL: $64.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $64.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 Iicensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civilpenaltyof not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U 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). ❑ 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 Iicensure 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. 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 Busin as a rofessions Code, and my license is in full force and effect. License Class License No D e `7 ' 2 /C Contractor Sign re /� NORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES U TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for `ormance oft Me work for which this permit is issued. Policy No. pad and win rA'intain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensal Ira se carri$r WVdiolicy number are: rier Policy Number Expiration Date 4ameof Agent rnune 01 cerr,ify that' jpthe Performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become s :hat,• ff I should be s eco bj to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos, Slgp;f rkof �pll _ r oy-�r to the workers' compensation laws of California, and IECLA, SI ON REGARDING CONSTRUCTIONLENDING AGENCY r Fiereb• a rm nder anal[ of er u that there is a construction lending agency for the performance of the work for which this permit is issued Section 3097, Civil Code). Y Y $ Y P 1 ry 9 9 Y P endel's Name .... Lender's Address .!tVsignature beld , I certify to each of the following: ••. • Pam the proper{powner 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 nd county ordinances and state laws relating to building construction. I authorize representatives of th cit r county o e ter t a above -identified propert .for inspection purposes. �� Jt 1�0 f e ionature of Prooertv Owner or Autho d Aoent Print Property Owner's or Authorized Agent's me (J ACTION I GATE I BY I PERMITEXP7RED I I I I PERMITCANCELLED I I I PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED 61 OF TITLE40 AND AQMDRULE 1403. I SUBMITTED ASBESTOS N071FICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS N07IRCAROMIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: