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HomeMy WebLinkAboutP2011-0470 - Permits(1) City of Newport Beach Building Division PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Job Address: 6 SCENIC BLUFF Bldg: 1 Floor: Suite: Description of Work: PLUM/ R/R GAS LINE TO EXTG FIREPLACE (X2011-1618) Inspector Area: 6 Code Edit 2010 Legal Description: N TR 15818 LOT 13 Owner: SANTORO FAMILY TRUST Contractor: GUENTHNER VON CONSTRUCTION Address: 6 SCENIC BLUFF Address: 30367 PASEO DEL VALLE NEWPORT COAST, CA 92657 LAGUNA NIGUEL CA 92677 Phone: Phone: 714-632-8565 Con State Lic:566158 Issued Date:11/1612011�Lic Expire: 09/30/2012 i� Bus Lic: BT00012584 Processed By: Lic Exp Date: 11/30/2011 Ij PLUMBING Permit No: P2011-0470 Inspection Requests/Telephone Worker's Compensation Insurance - Carrier : STATE FUND Policy No:1137739 Expire : 07/01/2012 Bathroom Fixtures Kitchen Fixtures Misc. Misc. Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 0 $0.00 Roof Drain: 0 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Grease Trap: 0 Urinal 0 $0.00 Bar Sink: 0 $0.00 Water Heater: 0 $0.00 Grease Interceptor:0 Bath Tub: 0 $0.00 Vegetable Sink: 0 $0.00 Gas up to 4 outlets: 1 $7.00 P-Trap: 0 Shower Stall: 0 $0.00 Ice Maker: 0 $0.00 Gas over 4 outlets: 0 $0.00 Sewer Wash Basin: 0 $0.00 Dishwasher: 0 $0.00 Backflow up to 2": 0 $0.00 Sewer: 0 Hydra -Mass Tub:0 $0.00 Lndry/Trap: 0 $0.00 Backflow over2": 0 $0.00 Sewer Alter/Repair:0 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 TOTAL: $17.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Other I NSP`�TOR $0.60 $3:CC. RecordMgmtFee:;- $rV.30 Investigation: $0.00 Plan Check: $0.00 Issuance: $0.00 Supplemental Fee: $9.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $17.00 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 items) - (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 legal) 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:http://www.leginfo.ca.gov/calaw. html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the siness and Ell;oftssions Code, and my li e i in f force and effect. (I r I (/% License Class License No Da / ^ — �/ Contractonature W%)RhFRS' CGMPESJSATION DECLARATION WARNING: 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 J$100,0001, IN ADDITION TO THE COST OF rOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I nereDy affirm under penalty of perjury one of the following declarations: 1 have and will manitain 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 th 0e ance of tho�xa-k for which this permit is issued. Policy No. i"e 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' compensatio I,surance carrier and policy number are: ,arfler_ . Policy Number Expiration Date Blame of Agent Phone # 2 a,iJfy that, kr the. ejLrformance 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 agre that, if I should bbr�eec��ome subj t he workers' compen to pro - of Section 3700 of the Labor Code, I shall forthwith comply with those pr visions. Signature of Applpyant�tae fL_1(�L� DECLARATION'REGARDING CONSTRUCTION`LENDI AGENCY I hereby 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). Lender's Name Lender's Address By 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 county ordinances and state relating to building construction. I authorize representatives of this city or county er the above-identi o y for inspection purposes. Signature of Property Owner or Author Agent MZ Print Property Owner's or Authorized Agent' me X ACTION DATE BY DECLAR4 7/ON OF COMPLIANCEWfTN CODE OF FOR OFRCE USE ONLY FEDERAL REGULATIONS PART 67 OF TITLE 46AND AOMD RULE 1403. PERMIT EXPIRED ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AOMD PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIRCAiTONISNOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL - 2 CERTIFICATEOF SIGNATURE: OCCUPANCYlSSUED