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HomeMy WebLinkAboutP2018-0266 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111111111 111� 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 8 0 2 6 6 H Permit Counter Phone (949)644-3288 Job Address: 1221 COAST HWY W Bldg: 1 Floor: Suite: Description of Work: COMM - R/R PUMP STATION EQUIPMENT & PIPING @'H' DOCK Inspector Area: 7 Code Edit 2016 Legal Description: IRVINE SUB BLK 54 LOT 171 POR OF LOT Owner: CITY OF NEWPORT BEACH Contractor: IRONWOOD PLUMBING INC Address: 100 CIVIC CENTER OR Address: 1315 N TUSTIN AVE #1387 NEWPORT BEACH CA 92660 oeeeo� ORANGE CA 92867 Phone: Phone: 714.639-0422 m Con State Lic:851742 Issued Date:08/09/2018 Lic Expire: 12/31/2018 • e Bus Lic: BT30022210 Processed By: Lic Exp Date: 02/28/2019 PLUMBING Permit: P2018-0266 see• Project No . • e same • ee o oeeeo� • • e o Inspection Requests Phone (949)644°3265 ® ,; m e m n em n mmo• Misc. • e m m e Other mm n o mm m m -• meeco mmme mamno m �� f. i•,• � m o Worker's Compensation Insurance Carrier: INS CO OF TH)4* Policy No:WSD5028472 Expire: 01/01/2019 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. 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 $0.00 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: $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: $28.71 Hydro -Mass Tub:0 $0.00 Lndry/Trap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:1 $33.00 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: $94.71 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $94.71 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. I hereby arn.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) 43estior`I 7031.5, Bysiness 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 perfnit to filt^%ned 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 BuTineSs and Prgfessions 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 Rot nage than five hundred dollars ($500). 1 I, as owner of Me psoperty, 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, e Business and PrbfeSsions 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 „igly jovemen(,S'atea nQt 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 j Qroyed for thespurpose of sale). Jessowner 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 No 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,W exempt frorrrlicensure under the Contractors' State License Law for the following reason: Bjy,signalurebelow 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) sets structhro'tbat9 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 Business and Prof ons de, and my license is in full force and effect. License Class License No D 9 ZO(�i Contractor Signatur NORKERS' COMPENSATION DECLARATION YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,00D(, IN ADDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: bI 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 the re rmance of the work for which this permit is issued. Policy No. PI ave 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' compensation urance carrier and policy numbfer are: 7T� r777 :arrier �IJ�,J'�nt'L Ctf DT'�l. I/wS4- Policy Number (/VC7% SOZU4i Expiration Date Jame of Agent Phone # ��— :3I certify that, in the performance_qfAhe 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 agree hat, if I should become\�subject orkers' ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �q signature Df Applicant Y t45t�' 0�.�� 18 CLARATION RE13AWNG CONSTRUCTION LENDING AGENCY a " ?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 ordin and state laws relating to building construction. I authorize representatives of this city or county to e r th ove-identified property for inspection purposes. n nature of Property Owner or Authorized Agent 1 Print Property Owner's or Authorized Agent's Name�� AC7701V DATE BY DECLARATION OF COMPLIANCEWITH CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMDRULE4403. PERMITEXPIRED ❑ I SUBMITTEDASB€STOS NODFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS M017FTCAITOMIS NOTAPPLICABLE TO PROPOSEDDEMOLITION. PERMITFINAL Q •'try,. CERTIFICATEOF SIGNATURE. OCCUPANCYISSUEO