HomeMy WebLinkAboutP2018-0298 - Permits1SO!VQ,UG,.-O�
City of Newport Beach - Building Division IIIII IIII IIII II III IIIIIIII IIIII III I II
100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 8 0 2 9 8
Permit Counter Phone (949)644-3288
Job Address: 513 MARIGOLD AVE Bldg: 1 Floor: Suite:
Description of Work: CHANGE OUT WATER HEATER "STOP WORK" (LOCATED IN THE BACK)
Inspector Area: 5 Code Edit 2016
Legal Description: CORONA DEL MAR BLK 539 LOT 13
Owner: AHMADI BEHROOZ Contractor: OWNER/BLDR
Address: 19 MUIR BEACH CIR Address: AHMADI BEHROOZ
CORONA DEL MAR, CA 92625
Phone: 949-760-8868 Phone:
Con State Lic:O/B
Issued Date:08/31/2018 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
PLUMBING Permit: P2018-0298
Project No:
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier :
Policy No:
Expire :
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
$0.60
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
$15.00
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:
$15.00
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
Lndryffrep:
0
$0.00
Backflow, over 2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
$33.00
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:
$63.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance: $63.00
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 :o 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 Cede: 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
imprqyetnents 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
imp ed 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
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 legally
sell a structure that I have built as an owner -builder if Pas not been constructed in its entirety by Iic need contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions_ Goda, is available upon request when ' application is submitted or at tbleyfollowirl� site:http://wwv�leginfo.ca.gov/calaw.html. I
Signature of Prcp33y Owner or Authorized Agent LJ �) i Date
LICENSED CONT6iACTOR'S DECLARATION
I hereby affirm'Inder penalty of perjury that I aM licensed under provisions of Chapter 9 (correncing with Section 70 0) of Division 3 of the Business and Professions Code, and my license is in full force
and effect.
Lice,ise Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: 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
:')^T CF COMPEkSATIOP','IAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
5rmly affirm under penalty of perjury one of the following declarations:
f 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.ttio+uork for which this permit is issued. Policy No.
na,,e and will 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' compensa
Dance carri'ar and policy number are:
Policy Number
Date
ie of Agent Phone #
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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
�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.
I agree to comply with all applicable city and county ordinanc s nd state laws relating to building construction. Vim'
I authorize representatives of this city or county to the Identifi d property for inspection purposes. ° /
nature of Property Owner or Authorized Agent/ 1 —% Print Property Owner's or Authorized Agent's Name Dgte/`
ACTION
DATE
BY
DECLARATION OFCOMPLIANCE WITH CODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART fit OFTITLE40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS NOTfFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATIONIS NOTAPPLICASLE TO
PROPOSED DEMOLITION.
PERMITFINAL
5' / —1
CERT RCATE OF
SIGNATURE:
OCCUPANCYISSUED