HomeMy WebLinkAboutP2018-0294 - PermitsCity of Newport
Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIII�IIIIIII'llllll II
100 Citic;eit�r D€ivy, Newport Beach, CA 92660 P 2 0 1 8 0 2 9 4
PermihCo3:nVr PhQn�(949)644-3288
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Job Aedliiesse 037 0-AVIONION '918g: ? Floor: Suite:
Description of Work: PLUMB - 3/4" WATERLINE FOR IRRIGATION SYSTEM & NEW HOSE BIBB
Inspector Area: 6 Code Edit 2016
Legal Description: N TR 14571 LOT 29
Owner: SPOKOYNY FELIX
Contractor:
TREEIUM INC
Address: 37 AVIGNON
Address:
5352 LAUREL CANYON BLVD #200
NEWPORT COAST, CA 92657
FEES
VALLEY VILLAGE CA 91607
Phone:
Phone:
855-833-8733
Bathroom Fixtures
Con State Lic:617148
Kitchen Fixtures
Issued Date:08/29/2018
Lie Expire:
04/30/2019
Bus Lie:
BT30053191
Processed By:
Lie Exp Date:
11/30/2018
PLUMBING Permit: P2018-0294
Project No: 0204-2018
Inspection Requests Phone (949)644-3255
Worker's Compensation Insu
Carrier: CAROLINA CA L'.W�
Policy No:BNUWC0144084
Expire : 05/18/2019
' 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.
FEES
Bathroom Fixtures
Kitchen Fixtures
Misc.
Misc.
Other
Toilet:
0
$0.00
Kitchen Sink:
0
$0.00
Water Piping:
1
$6.00
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:
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
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 over 2":
0
$0.00
Sewer Alter/Repair:0
$0.00
Issuance:
$0.00
Floor Sink:
0
$0.00
Regulator:
0
$0.00
Hose Bibb:
1
$13.00
Sewer Abandon: 0
$0.00
Supplemental Fee:
$9.00
Floor Drain:
0
$0.00
Lawn Sprinkler:
0
$0.00
Drinking Fountain:
0
$0.00
Additional Fee :
$0.00
TOTAL:
$28.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance: $28.00
' PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
OWNER -BUILDER DECLARATION •• ••• • • ••
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have••plicedfiexte o the appliceple ite1, n(s)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to it lwuanae, Als$ r4gyjre$ tV 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•700d) of Dlvisiolt3 of tale Business and
Professions Code) or that he or she is exempt from licensure and the basisfor 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 L) portions of the work, and the structure is not intendVorfifer ed for sales Noctior.?W4„
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, buildsrorimproves tha,plop4{ty, {llro�dl d 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 1e4buscrop of p%vUig timet it was rot guiii 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 legally
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 Business and Professions Code, and my license is in full force
and effect. c� '
License Class License No Da -1 U Contractor SignatudaV
NORKERS' COMPENSATION DECLARATION
YARNING: 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
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
NI 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 IN
Ie ormance of the work for which this permit is issued. Policy No.
�
I ave 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
su nce carrier and policy number are:
;arrier C00i'a i i 11C1 CQSI.(CII�� Policy Number [l)nu WGO I� a-slj Expiration Date rjIS'
Jame of Agent Phone #
:1I 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 agree
hat, if I should become
subject to the workers' colnpertsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iignature of Applicant//�' 33 Dt
Heby 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 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 laws relating to building construction.
I authorize representatives of this city or county to enter the above-id�e. '.d property for inspection purposes.
nature of Prooertv Owner or Authorized ADedf� a7�"•"`" Print Property Owners or Authorized Agent's NamRI Di IVIG 5heGhG6''I _Date
Ot si (7iT��ilir��;i7
PERMITEXPIRED
" ---- -"'-'
1 SUBWTTED ASBESTOS N071F1CATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
❑ ASBESTOSNOURCATIONIS NOT.APPLICABL.E TO
PROPOSED DEMOLITION.
PERMIT FINAL 17 ( —
CERTIF/CATEOF
SIGNATURE:
OCCUPANCYfSSUED