HomeMy WebLinkAboutP2019-0106 - PermitsCity of Newport Beach - Building Division III'lllllllll'IIIIIIIIIIII�IIIIIIIIIIII�III II
PLUMBING Permit: P2019-0106
100 Civic Center Drive, Newport Beach, CA 92660 P 2 1 9 0 1 0 6
Permit Counter Phone (949)644-3288
Project No :0748-2019
FEES
Inspection Requests Phone (949)644-3255
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Bathroom Fixtures
Kitchen Fixtures
Misc.
Misc.
Job Address: 829 PRODUCTION PL Bldg: 1 Floor: Suite:
Other
H I?
Description of Work: COMM PLUMBING - REPIPE EXTG GAS SYSTEM FOR 5 PSI @ ROOF (EXTG EQUIPMENT TO REMAIN)
0
$0.00
Kitchen Sink:
0
Inspector Area: 7 Code Edit 2016
Water Piping:
F�
Legal Description: N TR 3145 LOT 5
Roof Drain: 0
f`
Bidet
0
$0.00
Garbage Disp:
Owner: HIXSON METAL FINISHING Contractor: OWNER/BLDR
Worker's Compensation Insurance -
Address: 829 PRODUCTION PL Address: GREENE BRUCE
Carrier:
$0.00
NEWPORT BEACH, C 92663 O/B AUTH ATTACHED
Policy No:
Phone: 949-722-3459 Phone:
Expire :
• ° n m ° °
Con State Lic:O/B
Bar Sink:
°CSP° 00m°•C
Issued Date:04/04/2019 Lic Expire:
Water Heater:
°
Bus Lic:
Grease Interceptor.0
ooam
°
s ° o
Processed By: Lic Exp Date:
°mem
e o 0
Demo ° opo
00 °
04°G
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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
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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
Bidet
0
$0.00
Garbage Disp:
0
$0.00
Water Softener:
0
$0.00
Grease Trap: 0
$0.00
40.90
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:
$6.09
Hydro -Mass Tub:O
$0.00
Lndryfrrap:
0
$0.00
Backflow over 2":
0
$0.00
SewerAlterlRepair: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 :
$188.00
TOTAL:
$236.09
Plan Check Fee:
$0.00
Fee Due at Permit Issuance : $236.09
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 sole compensation, will do U all of or (_) 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
kJ roved for the purpose of sale).
,� 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).
IJ I 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 legall
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sell a structure that I have built as an owneF builder if Oras. not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 o t a Business and I,
Professions Code, is available upon request when s applicatio Is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent r----- Date O O'4 1 0)
.... LICENSED CONTRACTOR'S DE RATION
I hereby affirm ander fJeralty, 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.
QCeh9A:,lass "'; License No Date Contractor Signature
WORKERS' COWNSATION DECLARATION
N&RNIMG, FAILURE TO %ECURE 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
COST OF COMPENSAl @Ne DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
kerebby�affirm undeF}Jenalty, of perjury one of the following declarations:
I,Iyalre. and 4111*intain 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 the
3ed'gfTgflce of the aFertMor 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,4ld Zcy number are:
Policy Number Expiration 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 became subject to the workers' compensation laws of California, and
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant nate
DECLARATION REGARDING CONSTRUCTION LENDING 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 coun - ordinances and state laws relating to building construction.
I authorize representatives of this city or count o enter the above -identified property for inspection purposes.
Signature of Pronertv Owner or Authorized Aoe - P_ -i -.—b,- Print Prooertv Owner's or Authorized Acent's Name1 D1t;_ C4LEe-I1;9 Date -,(`l/ Iq
ACTION DATE BY
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CERTIFICATE OF
SIGNATURE:
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