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HomeMy WebLinkAboutP2020-0177 - PermitsCity of Newport Beach - Building Division 1pil111111111111111111111111111111111111111111p 11 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1830 HIGHLAND DR Bldg: IFloor: Suite: Description of Work: PLUM GASLINE TO BBQ & FIRE PIT Inspector Area: 3 Code Edit 2019 Legal Description: N TR 3057 LOT 48 Owner: ROTHBARD JEREMY Contractor: PROMONTORY POOLS INC Address: 1830 HIGHLAND DR Address: 17401 IRVINE BLVD STE B NEWPORT BEACH, CA 92660 TUSTIN CA 92780 Phone: Phone: 714-993-0554 Con State Lic:404194 Issued DateA1113/2020 Lic Expire: 03/31/2021 Bus Lic: Processed By:Lic Exp Date: BT30043247 05/31/2021 PLUMBING Permit: P2020-0177 Project No : 2099-2020 Inspection Requests Phone (949)644-3255 IN Worker's Compensation Insurance - Carrier: 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 $0.00 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 $7.00 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 over2": 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: $44.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $44.00 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. 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 sale compensation, will do L) all of or L) 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). ❑ 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 f,'om 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, sill a structure tHat I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Frofessicr.s Cuoe, 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 affinq r'nd':r penalty of perjury that I am licensed under provisions of Chapter 9 (commenciPtSRe, on 7000) of Division 3 of the Business nd P sSio ,o , a d my license is in full force and effect. License Clas; License No Da�3 %tJ_ Contractor Signatur 1VORKERS' COMPENSATION DECLARATION DARNING: FAILURE .O SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOAL PENALTIES AND CIVIL FINES UP TO ONE HUN RED THOUSAND DOLLARS l$100,0001, IN ADDITION TO THE ^CST]: COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereb/ affirm under renalty of perjury one of the following declarations: Land r�i;l nIa„intain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industdal Relations as provided for by Section 3700 of the Labor Code, for the ce ofthc :vark 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' compensatior carrier and policy number are: Policy Number Expiration Date of Agent Phone # certify that, in the perr nc oft for w c this permit is issued, I shall not employ any person in any manner so as to become subject to if I should become subj t t t rker co pe sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provis�pj iature of ADDlicant 7 _ Date 1 �reby affirm under pebAy bQpe75ry tFATthere Is a construction lending agency for the performance of the work for which this permit is issued 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 ha rovided I' cored I agree to comply with all applicable city and c y or ' an s e la s relating to building construction. I authorize representatives of this city or co n je r t abov -i ntif property for inspection purposes. Owners or Authorized compensation laws of California, and 3097, Civil Code). ACTION DATE DECLARATION OF COMPLIANCE INITN CODE OF FOR OFFICE U5E ONLY FEDERAL REGULATIONS PART 61 OF TI TLE40 AND AQMD RULE 1403. PERMITEXP{RED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS NORRCATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: