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Home My WebLink AboutP2017-0270 - Permits (2)1 City of Newport Beach - Building Division 111p11111p11p111111111p1111111p111111111p11p111 ai 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 7 0 2 7 0 F ' Permit Counter Phone (949)644-3288 Job Address: 2728 HILLTOP DR Bldg: 1 Floor: Suite: Description of Work: PLUM/ WATER HEATER C/O Inspector Area: It Code Edit 2016 Legal Description: 8787 LOT 4 UNIT 62 62A 62P 62B 62D 62GP OF PROJECT LOCATED Owner: KLEIN J Address: 272 LLTOP DR P N PORT BEACH, Phone: Issued Processed 4/2017 PLUMBING Permit: P2017-0270 Project No: Inspection Requests Phone (949)644-3255 i{ V a Worker's Compensation Insurance - .... Carrier: LIBERTY MUTUAL Policy No:WC2Z91464563025 ° e m = C Expire: 12/01/2017 mem.ms a ,mmm ammm Contractor: FAST WATER HEATER CO Address: 11715 NORTHCREEK PKWY#C106 92660 FEES BOTHELL WA 98011 Phone: 425-636-7084 Con State Lic:987398 Lic Expire: 10/31/2017 Misc. Bus Lic: BT30036541 Misc. Lietxp Date: 08/31/2017 PLUMBING Permit: P2017-0270 Project No: Inspection Requests Phone (949)644-3255 i{ V a Worker's Compensation Insurance - .... Carrier: LIBERTY MUTUAL Policy No:WC2Z91464563025 ° e m = C Expire: 12/01/2017 mem.ms a ,mmm ammm 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. m m ° me c mmmm° °mmmo:r .®dmoo .ommc 0 m000 FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other $0.0bm 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: 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: $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: $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: $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. m m ° me c mmmm° °mmmo:r .®dmoo .ommc 0 m000 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). ❑ 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 legail, 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 jt"E,•i§ 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 •1 hereby affirmunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cpde;-e d my license is in full force . • an8 affect. ` ^ \ / ticin a Class _• License No Date /r{ /' Contractor Signature Y ! SC� Pf$RKERS' COINPM'NSATION DECLARATION T_ - WNW FAILURE -9q, JECURE 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 33WQF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. -Nm@by affirm under penalty of perjury one of the following declarations: • °a¢e and 411 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 I�Fe444WW�o-.r nce of4l"werk for which this permit is issued. Policy No. .L.I-nay and will naintain 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' compensatiol nSdra a carni*,afid policy number are: , Policy Number re of Agent certify that, in the performance of the work for which , if I should become subject to the workers'' cempgns Date lermit is issued, I shall not employ any person in any manner so as to become subject to the workers' cgmp nsation laws of California, and provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. J Signature of Applicant - Date `' / DECLARATION REGARDING CCWSTRUfYION LEN I GENCY I hereby affirm unde penalty of perjury tha there is a cotfstruction 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 stat s rel It' g to building construction. I authorize representatives of this city or countyy to enter t �oTe-Ide♦tified rope for spection purposes. Signature of Property Owner or Authorized Agent l� 7`i1 st.- h`:: , Print Property Owner's or Authorized Agent's ACTION DATE BY ECLARATION OF COMPLIANCEWITH CODEOF FEDERAL REGULATIONSPART 61 OF T17IE40AND AQMD RULE 1403. ❑ I SUBMfTTEDASSESTOS NO77FICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIRCA770NIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: FOR OFFICE USE ONLY PERMIT EXPIRED PERMiTCANCELED PERMIT EXTENDED PERMITFINAL 7 3 0 CERTtFiCATE OF OCCOPANCYISSUED