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Home My WebLink AboutP2021-0454 - PermitsCity of Newport Beach - Building Division "P2021-0454* 4, 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 C � PLUMBING Permit: P2021-0454 Project No : Inspection Requests Phone (949)644-3255 Job Address: 3058 RIVOLI Bldg: 1 Floor: Suite: Description of Work: MFR WATER HEATER C/O Inspector Area: 4 Code Edit 2019 Legal Description: Owner: NEWPORT BLUFFS LLC Contractor: SCOTT PLUMBING INC Worker's Compensation Insurance - e Address: 550 NEWPORT CENTER DR Address: 10765 LAUREL AVE Carrier: INS OF THE WEST NEWPORT BEACH CA 92660 SANTA FE SPRINGS, CA 90670 Policy No:WSD502224508 Phone: Phone: 562-944-9793 Expire : 1110112021 a o - O C Con State Lic:813415 < ° Issued Date:1011412021 Lie Expire: 10131/2022 fl ° Bus Lie: BT30049015 oO4efp .° •°° Processed By: Lie Exp Date: 11/30/2021 m�eo tm : _ g 6OD°O O 90JC!' VV 4 FEES OU Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other n®acco oAu° 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 Hydra -Mass Tub:0 $0.00 Lndry/Trap: 0 $0.00 Backflow over2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $38.00 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: $69.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $69.00 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. 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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). 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 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 e"o,•il 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•herP•by affirm antler 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 my license is in full force • and effect. • ticenee Class _ License No Date D I�'1 Contractor Signatu WORKERS' C•BIOIAMSATION DECLARATION NARNING: FAILURF.W SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE COs'YOR JOMPENSATIOTI iDAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. •• •Ff2Td7y affirm und•. r penalty of perjury one of the following declarations: :•I�ave and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the Serformlince oftt1 Dort for which this permit is issued. Policy No. and will mairkain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier M p$licy number are: Policy Number of Agent Date I 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 t, if I should becom ubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi 'ens. (J mature of Applicant Date CLARATION REGA G CONSTRUCTION LENDING AGENCY =reby affirm under penalty o erjury that there is a construction lending agency for the performance of the work for which this permit is issued ( ection 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 coun ordinances and state laws relating to building construction. I authorize representatives of this city or count t enter the/ab�ve-identified propeqtfor inspection purposes. 1A, �,/ ('' I 1 mature of Property Owner or Authorized Agent ��//�- _ Print Property Owner's or Authorized Agent's NameX / 4J,�o �l PA 717f1 ACTION DATE BY DECLARATIONOF COMPLIANCE IMTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULARONSPART61 OF TITLE40AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS N077FICATION TO:. ❑ EPA ❑ AQMD PERMITCANCEtLED P€RMfTEXTENDED ❑ ASBESTOS N077FICATIONIS NOTAPPLICABLETO PROPOSED DEMOLITION. PERMITFINAL 2511 / S' CERTIFICATEOF OCCUPANCYiSSUED SIGNATURE:.