HomeMy WebLinkAboutP2018-0308 - PermitsGD�
City of Newport Beach - Building Division "P2018-0308'
100 Civic Center Drive, NewportBeach, CA 92660
HPermit Counter Phone (949)644-3288
Job Address: 369 NEWPORT GLEN CT Bldg: 1 Floor: Suite:
Description of Work: PLUM WATER HEATER C/O
Inspector Area: 8 Code Edit 2016
Legal Description: N TR 9776 LOT 4
Owner: CORRAL RUDY
Contractor:
PAYLESS WATER HEATERS
Address: 369 NEWPORT GLEN CT
Address:
27919 SMYTH DR
NEWPORT BEACH, CA 92660
VALENCIA CA 91355
Phone:
Phone:
661-775-2944
Con State Lic:836216
Issued Date:09/11/2018
Lic Expire:
08/31/2020
Bus Lic:
BT30041725
Processed By: (
Lic Exp Date:
12111/2018
PLUMBING Permit: P2018-0308
Project No :
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier: EMPLOYEE SVC GROUP
Policy No:C651978441
Expire:08101/2019
FEES
Bathroom Fixtures
Kitchen Fixtures
Misc.
0
$0.00
Misc.
Roof Drain: 0
$0.00
Other
$0.00
Toilet:
0
0
$0.00
$0.00
Kitchen Sink:
Garbage Disp:
0
0
$0.00
$0.00
Water Piping:
Water Softener:
0
$0.00
Grease Trap: 0
$0.00
$0.00
Bidet
Urinal
0
$0.00
Bar Sink:
0
$0.00
Water Heater:
1
$15.00
Grease Interceptor:0
$0.00
Fee:
$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
$0.00
Shower Stall:
0
$0.00
Ice Maker:
0
$0.00
Gas over 4 outlets:
0
$0.00
Sewer
0
$0.00
Investigation:
Plan Check:
$0.00
Wash Basin:
0
$0.00
Dishwasher:
0
0
$0.00
$0.00
Backflow up to 2":
Backflow over 2":
0
0
$0.00
$0.00
Sewer:
Sewer Alter/Repair:0
$0.00
Issuance:
$33.00
Hydro -Mass Tub:0
0
$0.00
$0.00
Lndry/Trap:
Regulator:
0
$0.00
Hose Bibb:
0
$0.00
Sewer Abandon: 0
$0.00
Supplemental Fee:
$0.00
Floor Sink:
Floor Drain:
0
$0.00
Lawn Sprinkler:
0
$0.00
Drinking Fountain:
0
$0.00
Additional Fee :
$0.00
TOTAL: $48.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance : $48.00
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 J 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).
3 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).
❑ 1 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 legall,
sell a structJre 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:/Aw .leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I :tereby affirm under penalty of perjury that I am licensed under proAL. ions of Chapter 9 (commencing h Sec' n 70 0) of Division 3 of the Business -f3 fessions Code, and my lice se is in full force
and effect. (�� /� j//,(
Cicensr Class` License No e�J ij ((ten Date l C Contractor Signat
IVUtt'KERS' CQSAPENSATION DECLARATION
VAPNINC�, FAILURE.TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPL ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOO NDRED THOUSAND DOLLARS (Ef 00,0001, IN in
TO THE
JOST OF COMPEN1 ,71C!, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEy'S FEES.
`:crrt� affiml under penalty of perjury one of the following declarations:
:' 1 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 th,
Ierformance of the work for which this permit is issued. Policy No.
have 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'
lance carrier and policy number are:
Policy Number
Date
is of Agent Phone # _
certify that, in the pe ormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to
if I should bec to the workers' compensa/ti�q'n pr isions of Section 3700 of the Labor Code, I shall forthwith comply with those provis/iy
Iature of Applica ( �ii1 DatP1
:reby affirm under p Ity of perjury that there is a construction lend agency for the performance of the work for which this permit is
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 pi
any owner's behalf.
I have read this application and the information I bay
provided is correct.
I agree to comply with all applicable city and co
dinances and state laws relating to building construction.
I authorize representatives of this city or COLD to n
above-identifi r rty for inspection purposes.
nature of Property Owner Dr Authorized Agent
Print Property Owner's or Authorized Agent
workers' compensation laws of California, and
3097, Civil Code).
ACTI01V
DATE
BY
DEQLAIIATION OF COMPLIANCE WITH CODE OF
FE L REGULATIONS PART 61 OF TfTLE40 AND
AQMDRULF 1403.
❑ I SUBMfTTEDASBFSTOS W17FICATION TO:
❑ EPA
❑ AQMD
ASBESTOS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
FOR OFFICE USE ON
97
PERMITEXPIRED
PERA41TCANCELLED
PERMITEXTENDED
PERMITFINAt
J J/Q$/ZJ
1fy or �'
CERTIFICATE OF
OCCUPANCY!SSUED