HomeMy WebLinkAboutP2020-0006 - Permits�,�t City of Newport Beach - Building Division IIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II PLUMBING Permit: P2020-0006
o 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 0 0 0 0 6 Project No:
,`-;_ Permit Counter Phone (949)644-3288
;tier ra'�`: Inspection Requests Phone (949)644-3255
Job Address: 2939 PERLA Bldg:1 Floor: Suite: INSPECTOR
Description of Work: PLUM/SINK C/O ONLY "AS BUILT" (OK PER CHO)
Inspector Area: 8 Code Edit 2019
Legal Description: N TR 7167 LOT 34
Owner: MCKINLEY DERRELL Contractor: OWNER/BLDR
Worker's Compensation Insurance -
Address: 2939 ERLA
Address:
Carrier:
NEW
RT BEACH, CA 92660
Policy No:
Pho 562-480
1346
Phone:
Expire
0
Con State Lic:O/B
Issu Date:01/10/20 0
Lic Expire:
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Bus Lic:
00
Processe q:
Lic Exp Date:.....
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FEES
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Bathroom Fixture
Kitchen Fixtures
Misc.
Misc.
Other
Toilet: 0
$0.00
Kitchen Sink: 0
$0.00
Water Piping:
0
$0.00
Roof Drain: 0
$0.00
'$O.Gbb
®E
Bidet 0
$0.00
GarbageDisp: 0
$0.00
Water Softener:
0
$0.00
Grease Trap: 0
$0.00
oQ.Vbm
mm°°
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: 2
$30.00
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:
$35.00
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:
$65.00
Plan Check Fee :
$0.00
Fee Due at Permit Issuance: $65.00
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 L) 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).
d 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 legalh
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 a tion is submi t o t th ollowing Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent �' Date — Z0
•••• LICENSED CONTRACTOR'S DECLARATION
!, herebKaffirm uMeTbenalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
�•a116 t:jfect. •:•••;
License Class • License No Date Contractor Signature
COMPENSATION DECLARATION
'AQIj,NIpNG' FOAILURE $F.�CyZE 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 T
$$55'' F� MPENS dN-d AGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
IfereVaffirm under p(linalty of perjury one of the following declarations:
1 ••
I •ha.ve and with IYMIMtain 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
• •••
e ormance of the work for which this permit is issued. Policy No.
I ITaveiind will fnaolCn 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' compensal
isurance carrier and policy number are:
•—
Agent "•••
Policy Number
Date
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 agree
could become subject to the workers' co�m/peenssation ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of Applicant )O y( —���UL�e% �j/-�`Y�,C'i Datp(D
,TIr)1U RPr:A�Nr: Cr1NRTRI 1CTInN�I F JF rnhir: .PNCv /
�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).
lder'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 owners 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 tormenter the above/ -i tifie property for inspection purposes. !�_,,
nature of Pronertv Owner or Authorized Anent N� fro lei a Print Prooertv Owner's or Authorized Aaent's Name 07710 A6 J %/ � G1lAllza r Date
ACTION I DATE
PERMITEXPIRED
PERMITCANCELLED
PERMITFINAL
CER77FfCAT€OF
OCCUPANCY[SSOED
BY ute-LAK fILIN Ur LUMVLLAAR-L rvr IIT wuc Ur
FEDERAL REGULATIONS PART 61 OF TIILE40AND
AQMD RULE 1403.
❑ I SUBMITT£DASBESTOS NOTIFICATION T0:
❑ EPA
❑ AQMD
❑ ASBESTOS NO77FICA7IONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
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