HomeMy WebLinkAboutP2016-0379 - Permitst'�4 City of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
a+ 100 Civic Center Drive, Newport Beach, CA 92660
K t, Permit Counter Phone (949)644-3288
P'3`S'9F6'tt n
Job Address: 23 VIA PALLADIO Bldg: 1 Floor: Suite:
Description of Work: PLUMB INSTIL GAS FOR BBQ, FIRE PIT, AND POOL HEATER
Inspector Area: 6 Code Edit 2013
Legal Description: N TR 14070 LOT 92
Owner: DHILLON KIMVIR & PRIVA
Contractor:
VER BURG CJ LANDSCAPE DESIGN
Address: 23 VIA PALLADIO
Address:
24131 AMURRO DR
NEWPORT BEACH, CA 92657
MISSION VIEJO, CA 92691
Phone:
Phone:
949-939 1254
Con State Lic:484997
Issued Date:07/13/2016
Lic Expire:
0413012018
Bus Lic:
BT30055837
Processed ByL
Lic Exp Date:
07/31/2017
PLUMBING Permit: P2016-0379
Project No :
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier : WIC EXEMPT
Policy No:(NO EMPLOYEES)
Expire :
•
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
0.6000 •
° ° °
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:
1
$6.00
P-Trap: 0
$0.00
Record Mgmt Fee:
J ° $6 0
......
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:
$0a00
• °
Hydro -Mass Tub:0
$0.00
Lndry/Trap:
0
$0.00
Backflow over2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
• $32 00
°
Floor Sink:
0
$0.00
Regulator:
0
$0.00
Hose Bibb:
0
$0.00
Sewer Abandon: 0
$0.00
Supplemental Fee:.
• -p.00
oee•o
Floor Drain:
0
$0.00
Lawn Sprinkler:
0
$0.00
Drinking Fountain:
0
$0.00
Additional Fee:
$0.00
°
•oe•
TOTAL:
$38.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance: $38.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
il
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 U 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 legall,
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:hftp://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent e
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000 r of Division 3 of the Busi as • s d d ice a is in f orce
and effect.]
License Class License No CJ e b f lC� Contr� r /net
NORKERS' COMPENSATION DECLARATION
WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIyA FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), II ADDITION TO THE
IGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES ''-
hereby affirm dht8i0penalty of perjury one of the following declarations:
TI ;ave and will maintain a certificate of consent to self -insure for workers' compensation,
trforjnance of the work for which this permit is issued. Policy No.
71 have and wil maiptain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
Isurance carrierar0policy number are:
Policy Number
issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
Date
e4rtify that, in the performance of the w foo h this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
'if P_should.become subject tDAW`:e0 c s-atj¢n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. J
of
of perjury that there is a construction le ing agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property
I have read this application and the information I have provic
I agree to comply with all applicable city and county
I authorize representatives of this city or coun
Ter's behalf.
is correct.
apUptate laws relating to building construction.
"Mri d ro rt for inspection purposes.
Print Property Owner's or Authorized
AC17ON
ATE
BY
]DECLARATION OF COMPLIANCEtMTLI CODE OF
FOROFFR.EUSEONLY
FEDERAL REGULA 17ONS PART 61 OF TIILE40AND
AQMD RULE 1403.
PERMITEXPIREO
❑ ISUBMITIEDASBESTOSN07IFICATIONTO.-
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIRCAAON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMtTCANCELLED
PERMIT EXTENDED
PERMIT ftNAL
7-L$-14
D( I� for.. 7
C€RTIFICATEOF
SIGNATURE.
OCCUPANCYISSUED