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HomeMy WebLinkAboutP2021-0180 - PermitsCity of Newport Beach - Building Division I 111�111111111111p11111p11111111111p11111p111111p111 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 1 0 1 8 0 °a T^ Permit Counter Phone (949)644-3288 ri°cras��`''a Job Address: 3141 COLONY PLZ Bldg: 1 Floor: Suite: Description of Work: PLUMB - WATER HEATER C/O Inspector Area: q Code Edit 2019 Legal Description: Owner: IRVINE CO Contractor: SCOTT PLUMBING INC Address: 111 INNOVATION Address: 10765 LAUREL AVE IRVINE CA 92618 FEES SANTA FE SPRINGS, CA 90670 Phone: Phone: 562-944-9793 Con State Lic:813415 Issued Date:06/11/2021 Lie Expire: 10/31/2022 �,j Bus Lie: BT30049016 Processed By: `J 1 Lie Exp Date: 11/30/2021 PLUMBING Permit: P2021-0180 Project No: Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier: INS OF THE WEST Policy No:WSD502224508 Expire : 11/01/2021 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. o ee eee oce 0 c � 0 °C o 0 occ u c � °` cc coo 000 0 u c <' wo coo uco 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: 1 $31.00 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: $37.00 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: $66.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $68.00 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. o ee eee oce 0 c � 0 °C o 0 occ u c � °` cc coo 000 0 u c <' wo coo uco OWNER -BUILDER 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-Builderwill have the burden of proving that it was not built or improved for the purpose of sale). ❑ 1, 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 legally 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 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 Professions Code, and m license is in full force and effect. License Class License No Date �� Contractor Signatures NORKERS' COMPENSATION DECLARATION NARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm 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 thI aerformance of the work for which this permit is issued. Policy No. �Y(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' compensatior 0n%stfrance carrier and policy number are: arrler Policy Number Expiration Date Vame of Agent Phone # :1I 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 agree :hat, if I should become subject to the workers' compen tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant! ""—" Date ., (0//1/02/ IECLARATION REGKIRDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is ender's Name Lender's Address ly 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 to enter the above-identifie o rty for inspection purposes. lianature of Prooertv Owner or Authorized Aqent Print Property Owner's or Authorized Agent (Section 3097, Civil Code). ACTION DATE BY UCLLAI II VR VI' 4ViWYL1AlYLC VVI I rI LVUC VV run urrl d vaZ ulvc. FEDERAL REGULATIONSPART61 OF TITLE40AND • AQMD RULE 1403. � ••• ••• ••• ••• PERMITEXPIRED ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: : : EPA ••• ❑ AQMD :• ••• •--- •: �� • •• PERMITCANCELLED❑ PERMITEXTENDED ❑ ASBESTOS M017FICATI01VIS NOT APPLICABLE TO PROPOSED DEMOLITION. s PERMIT FINAL } y CERTIFICATEOF SIGNATURE: • • • • • •• OCCDPANCYFSSDED • . • Date