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Home My WebLink AboutP2015-0453 - PermitsCity of Newport Beach - Building Division 111p111111111p11111p11111111111p111111111111111111 y rd 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 5 0 4 5 3 h Permit Counter Phone (949)644-3288 V � $ �'ailPlPN�a Job Address: 3 VIA NAPLES Bldg: 1 Floor: Suite: Description of Work: PLUM -CHANGE OUT 75 GAL WATER HEATER Inspector Area: 6 Code Edit 2013 Legal Description: TR NO 14070 LOT 68 FOR OF LOT AND FOR OF LOT L Owner: CHIA WENG-KWEN RAYMOND Contractor: FAST WATER HEATER CO Address: 3 VIA NAPLES Address: 11715 NORTHCREEK PKWY#C106 NEWPORT COAST, CA 92657 BOTHELL WA 98011 Phone: Phone: 425-636-7084 Con State Lic:987398 Issued Date:10/13/2015 Lic Expire: 10/3112015 Bus Lic: BT30036541 Processed By: Lic Exp Date: 08/31/2016 PLUMBING Permit: P2015-0453 Project No : Inspection Requests Worker's Compensation Insurance Carrier: CYPRESS INS CO Policy No:FAWC500990 Expire : 12/01 /2015 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 $15.00 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 Backftow 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 BackOow 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: $50.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $50.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature belcw 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 Wit 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.c-a.gov/calaw.html. Sign: ture of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION 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 Profs ions Coos, and my license is in full force and effect. L,/ ? / 15 Contractor O :ence Class License No Date 'J Signature WORKERS' XNNIP�ENSATION DECLARATION WARNINu: 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 ($100,000), IN ADDITION TO THE COoi OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. oweu� affirm under penalty of perjury one of the following declarations: L7 I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thI is ,$gn3nce of tI,E work for which this permit is issued. Policy No. - 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' carrier and policy number are: Policy Number of Agent Date 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 if I should become suboet tp the worker§' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of GLARATION REGARDING CONSTRUCTIOR LENDING AGENCY Ireby 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). 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 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 entr„tfle p4ava-identjfpd property for inspection purposes. �_ _ „ A 110 [Signature of Property Owner or Authorized Agent - Print Property Owners or Authorized Agent's Name L% 1'F Date w/L ACTION DATE BY DECLARATION OF COMPLIANCE IMTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND PERMIT EXPIRED AQMD RULE 1403. ❑ I SUBWTFEDASBESTOS NOTIFICATION TO: PERMITCANCELLED ❑ EPA PERMITIXTENDED i ❑ AQMD PERMIT FINAL j(; ry=T = PF'1'r" F� P❑ROPOSED DEMOLITION. ASBESTOS HONIS NOT APPLICABLE TO CERTIFICATEOF - jI OCCUPANCYISSUED 1 SIGNATURE: