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HomeMy WebLinkAboutP2021-0245 - Permits (3)Ew,.,,{? City of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111 PLUMBING Permit: P2021-0245 j+' '�,� 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 2 4 5 Project No �. �> Permit Counter Phone (949)644-3288 „ . y 'µN`�, Inspection Requests Phone (949)644-3255 Job Address: 2421 SIERRA VISTA Bldg: 1 Floor: Suite: Description of Work: SFR REPLACE SEWER DRAIN UNDER HOUSE (CAST IRON TO ASS PIPE) 70 SF Inspector Area: 3 Code Edit 2019 Legal Description: N TR 1801 LOT 6 Owner: DEKEYZER MARILYN Address: 2421 SIERRA VISTA NEWPORT BEACH, CA 92660 Phone: 949-275-2257 Issued Date:07/23/2021 Processed By: Contractor: RESCUE ROOTER Address: 740 N HARITON ST ORANGE CA 92868 Phone: 714-771-8471 Con State Lic:765155 Lic Expire: 07/31/2022 Bus Lic: BT30046061 Lic Exp Date: 02/2812022 Worker's Compensation Insurance - Carrier: LIBERTY MUTUAL Policy No:WA763D508631 Expire : 10101/2021 FEES Bathroom Fixtures Toilet: 0 $0.00 Kitchen Fixtures Kitchen Sink: 0 $0.00 Misc. Water Piping: 0 $0.00 Misc. Roof Drain: 0 $0.00 Other I i $0.30 II ' 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: $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 MOO Sewer: 0 $0.00 Plan Check: $0.00 Hydro -Mass Tub:0 $0.00 LndryfTrap: 0 $0.00 Backflow overt": 0 $0.00 Sewer Alter/Repair:1 $39.00 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: $77.00 Plan Check Fee : $77.00 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 (_) 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 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 legal) 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 affirn.:Jrder 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 a. J effect. 1� yy o License ClaSs License No Date �7- �2� Contractor Signature / WORKERS' COMPENSATION DECLARATION WARNING: FAILUP`_ TO. SFCURE 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 IDOSS OF COMPLNSA-IOr'. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I h1eieby affirm under penalty of perjury one of the following declarations: lu I ;lave 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 th OfeI 9rmance of the work for which this permit is issued. Policy No. gave and Nill 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' compensatio Insurance carrier anti policy number are: Carn3r Policy Number Expiration Date Name of Agent _ Phone # I 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 agre that, if I should become subject to the work e/,ry�co�rr}[�ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature Signature of Applicant ! � "" "" `� Date / LJ�-21 DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby 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). Lender's Name Lender's Address By 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. I authorize representatives of this city or county t nter the v entified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name/ �ptZ �, )r Date Z ACTlOP! DATE SY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 89 OF Tt71E40 AND AO+WD RULE 9403. ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD.. ❑ ASBESTOS N077P7CAI10NlS NOT APPLICABLE 70 PROPOSED DEMOLITION. SIGNATURE: FOR OFFICE USE ONLY PERMIT EXPIRED PERMI7 CANCELLER PERMITEXTENDED PERMIT FINAL CERT6`lCA TEOF OCCUPANCY'fSSUED