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HomeMy WebLinkAboutP2020-0098 - Permitst City cfivo Center Drive, BeaNewporehachBuilding Division IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIII II PLUMBING Permit: P2020-0098 Permit Counter Phone (949)644-3268 Project No: 2830-2019 "�'[rr.�ti.�`� Inspection Requests Phone (949)644-3255 Job Address: 3403 FINLEY AVE Bldg: 1 Floor: Suite Description of Work: PLUM (2) WATER HEATER CHANGE OUTS z Inspector Area: 1 Code Edit 2016 3, 0 Legal Description: CANAL SECTION BILK 434 LOT 2 Owner: SPIELER NORMAN Contractor: AMERICAN WEST SERVICES Worker's Compensation Insurance - zZ Address: 5550 TOPANGA CANYON BLVD 3350 Address: 921 BAYWOOD DRIVE .... , (° Cn Carrier: STATE FARM • • WOODLAND HILLS CA 91367 NEWPORT BEACH CA 92660 Policy No:92GKH3474• Phone: Phone: 949-683-7410 Expire 03/0812021 Con State Lic:748965 Issued Date:07/06/2020 Lic Expire: 05/31/2022 '•° o S Bus Lic: BT98041665 Processed By: Lic Exp Date: 03/31/2021 o ° • �° V • • f ®O•UO • O FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other °••°�• M... ` 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: 2 $34.00 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 Lndryfrrap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair l) $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: $69.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $69.00 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 sole compensation, will do (_) 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 improved for the purpose of sale). 3 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). ❑ 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 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:hftp://www.leginfo.ca.gov/calaw.html. Signature of Rroper?y Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION •J4fepy affirrji upBe?r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the Business anc rofas i ns Code h@ , nd m license is in full force • L / ((�� ) / ,L'geA Ceass C` `z—� License No ` (J hS Date �/�Contractor Signature MOWERS' gOMPENSATI N DECLARATION 11ARNIN01 FAILURE4OTIPCURE 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 MSI•(YF COMPENS®Tial DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ll+efelry affirm dnd%penalty of perjury one of the following declarations: 51"ave 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 the Ice of l.e wark for which this permit is issued. Policy No. and!wilt Mairf[ain workers' compensation insurance, as required by Section 3700 of the Labor Code, carrier eRd policy number are: _. •••• Policy Number 1e of Agent certify that, in the pi if I should become lature of Applicant - for the performance of the work for which this permit is issued. My workers' Date of twork for which this pe it is issued, I shall not employ any person in any manner so as to become subject to the he rkers' comoens�tion revisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. rreby affirm under penalty of perjury that there 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 have provided is correct. I agree to comply with all applicable city and county 0 dinanc and state laws relating to building construction. I authorize representatives of this city or county toe er t e -idents led operty for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ACT70N DATE BY 11 DECLARATION OF COMPLIANCE MTHCODEOF work s' compensation laws of California, and ag & -ZU 3097, Civil Code). V V `JY1 r Date �/ L AQMD RULE 1403, P€RMITEXPIRED ❑ I StBMITTEDASBESTOS NOTIFICATION T0: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIRCATIONIS NOTAPPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATE OF '1 SIGNATURE: OCCUPANCYISSUED work s' compensation laws of California, and ag & -ZU 3097, Civil Code). V V `JY1 r Date �/ L