HomeMy WebLinkAboutP2014-0369 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIINIIIIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 4 0 3 6 9
Permit Counter Phone (949)644-3288
Job Address: 3 BEACON BAY Bldg: I Floor: Suite:
Description of Work: PLUMB/ MAINLINE CLEAN OUT
PLUMBING Permit: P2014-0369
Project No :
Inspection Requests Phone (949)644-3255
7— 7,
Inspector Area. 2 Code Edit 2013
Legal Description: R S 009-42 PAR 3 POR OF PAR AND POR OF PAR 2
AIN
Owner: RAMSEYPAUL Contractor: COL RVICES ,I,. -ov Qorker�s Compens -In rance -
Address: 3 BEACON BAY Address. —=52 �TRASK AVE Carrier :,�RITYNA IONAL
NEWPORT BEACH, CA 92660 G DEN A 92843 5�\
��RFCJ , Reh6y�No:SWC1037574
Phone: P. " 1 —0-
onM. 7 7 :5 Expire 01/01/2015
"N
8978
Issued Date:07117120114 2 Bus Lic:: 3
. . . . .....
Processed BV: L ii .
10, 1 1 -- - % - 1 0
"Al -71
lzlo4
LR
'r.
Bathroom Fixtures KiWWYIxtures
Mip C.,
-A 0 her
Toilet: 0 $0.00 �X Kitchen 0 ;Ker Piping: 0 t 0.00 $006
yk 0 M, 9
0 ill @Q Water Softener: 0 0 a 0.00 C,3" Bidet 0 $000 �Gar Tr
V
Urinal 0 $0.00 ar A Water Heater 0 r eptor:O $0.00
S I
B.4
Bath Tub: 0 $0.00 get 0 $0.00 Gas up tg,4 ets: 0 p: 0 1 e:
Shower Stall: 0 $0.00 110-6 lvla60 $0.00 A121 Its: 0 .00 Sewer ig t, o $opo ...
0 $0.00 Di washer: 0 $0.00,, V-1A
Wash Basin: S:
V Ba - , M '1p to 2": 0 $0.00 Sewer: 0 -Check: .$0.09
1 backfi over 0 $0.00 w_ r Alter/R �32. Issuance:
Hydro -Mass Tub: 0 $0.00 In [Trap: Be -$"11� e
Floor Sink: 0 $0.00 Reg 'atop Hokil db: 0 $0 SevverAb n: .00 Supplemental] e: $0.("o
Floor Drain: 0 $0.00 Lawn 'a`pri1k,1,ec, n
0 $0 00,-,`,� -��rinking Fountain: 0.00
TOTAL: $66.0%, r 7-� h Check Fee" .0-,,�' Fee Due at Permit Issuance: $66.00
DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -BUILDER DECLARATION v�
I herebyaffirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons indicated below ..�Fre'checkmark I have laced next to the applicable item s
P Y PO rY P O (. P PP O
Section 7031.5 Business and Professions Code: An city or county that requires a permit to construct alter, improve, demoli re air an structure 'or to its issuance also requires the applicant for
( Y Y ty q P P a P Y �� Q us
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State Licer�� se-Eaw (Chapter 9 (commencing wl Section 7000) of Division 3 of the Business one
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violaporroT Section 7031.5 by any applicant fo a ermit subjects the applicant to a civil penalty o
lot more than five hundred dollars ($500). �rU�' a
I, as owner of the property, or my employees with wages as their sole compensation, will do U`all of or U portipns "ii work, and t r,3(rptfkhfe is not int
Business and Professions Code: The Contractors' State License Law does not apply to an owner of propertlF4 tio;sth'Tough employ, A,6Hpersonal effort, build]
improvements are not intended or offered for sale. If, however, the building gr improvement is sold within one year of ppm�yel lio4♦-the Owner -Builder will�����1aaaaawvv�va
improved for the purpose of sale). / '_� i^ 6f I, as owner of the property, am exclusively contracting with Ilekti§ed Co actors to y�strud the project (Sec n 7044, Business an�.W essions Code: The
apply to an owner of property who builds or improves thereon, a d ontra fo the a projects_with a}jcensed Contracts & Uar ttf to the Contractors' State L
❑ 1 am exempt from licensure under the Contracto ' State ices or the following,reason
led or offered for sale (Section 7044,
or improves the property, provided that the
pe burden of proving that it was not built or
3y my signature below I acknowledge that, exc r y esldence in which I mdst have -resided fora' least one year prior to completion of the improveme
sell a structure that I have built as an owner-buil r t as not een constructed iN its enbfety :by Ilon contractors. I understand that a copy of the applicable
Professions Code, is available upon. reques�h t is applicatlor2Js subtrutted'or*the (q.Ilowing-Web site:http://w .leginfo.ca.govlcalaw.html.
Signature of Property Owner or Authorized Agent
I hereby affirm under penal'
and effect.
License Class
NORKERS'COMPENSA
YARNING: FAILURE TO SECURE W
hereby affirm ender penalty of pedj
101•Mwe and.willnVntain a certi
erformance o:UA work forwhich th
.IVOe and wil6maintain workers'
isurance carrier and Qolicy number
an of Agent
the performance of the
come subject to the wq
iignature of Ap
FOR
41by affir1rf &Ver penalty of perjury that there Is a
ider's Name. • .. i
my signature below, I certify to each of the follo�iin.
I am the property owner or authorized to act on
I have read this application and the information I
I agree to comply with all applicable city and coun
I authorize representatives of this city or county to
nature of Property Owner or Authorized 49ent
Chapter
AN EMPLOYER TO
s6re for workers' compensation, issued by erector
No.
as required S l Z of Code, for the
of Division 3 of the Business and
ctors' State License Law does not
Law).
covered by this permit, I cannot lei.
Section
4�LTIE1571r� ClvdL,PINES UP01NE HUNDRED THOUSAND
to
{�06&Ar%I Relations as provi o ctJ
of the
in full force
($100,000), IN ADDITION TO THE
o"f the Labor Code, for the
My workers'
k^;55P 0E�#
died, I shall not emplo person m any -e so ecome subject to the workers' compensation laws of California, and agre
of Section 370�..a�aLLabor Code all fo�. comply with those provisions.
nL -'7/ /7/20/6
of the work for which this permit is issued (Section 3097, Civil Code).
Address
is correct.
and state laws relating to building construction.
d property for inspection purposes.
Print Property Owners or Authorized
At71ON
DATE
BY
DECLARATION OF COMPLIANCE MIR CODE OF
FOROFR EUSEONtr
FEDERAL REGULATIONS PART 61 OF THLE40AND
AQMD ROLE 1403.
PERMITEXPIRED
(
O7-L2--
❑ 1 SUBMTT€DASBESTOS M017FICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELL€D
PERMIT EXTENDED
❑ ASBESTOS NOT7RCA770NIS NOT APPLICABLE TO
PROPOSED DEMOLITR)N.
PERMIT FINAL
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED