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Home My WebLink AboutP2019-0025 - Permits, y,56'nry City ofCivic �Newport Drive,enter Beach oBeach, - Building og Division IIIIIIIIIIIIIIIIIII III IIIIIIIIIIIIII9IIIIIII� II Permit Counter Phone (949)644-3288 Job Address`. 3 NIGHTSHORE Bldg: 1 Floor: Suite: Description of Work: PLUM.GASLINE FROM SERVICE TO HOUSE Inspector Area: 6 Code Edit 2016 Legal Description: Owner: SOLEIMANY ALI HAGH Contractor AMERISERVE REPIPING CO INC Address: 3 NIGHTSHORE Address: 7716 BALBOA BLVD #7 NEWPORT BEACH CA 92657 PLUMBING Permit: P2019-0025 Project No: Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carder: MIDWEST VAN NUYS CA 91406 Policy No:BNUWC0141695 Phone: Phone: - 818-787-9777 - Expire : 09/14/2019 Con State Lic:855252 Issued Date:01/25/2019 Lie Expire: 0313112019 Bus Lie: BT30063781 Processed By: Lie Exp Date: 07/23/2019 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: 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: 1 $1.00 Sewer Investigation: $0.00 Wash Basin: 0 $0.00 Dishwasher: 0 $0.00 Backflowup 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: $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: $36.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $36.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7i00 a.m. to 6:30 p.m. and Saturday from 3:00 a.m. to 6:00 p.m. )WNER-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 toitsissuance, 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 rot more than five hundred dollars ($500). 1 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of It Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of con nproved for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, I apply to an owner cfproperty who builds or improves thereon, and who contracts for the projects with a licensed Contracto ❑ lam exemptfrom licensure under the Contractors' State License Law for the following reason: ysny.s•Ignaturebelow) acknowledge that, except for my personal residence in which I must have resided for at least one y sell 2 structdrEtRA3 have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I • PrEfessions Code, is available upon request when this application is submitted or at the following Web site:http://www.le Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I Aargey affirm Lfider penalty of perjury that I am licensed under provisions of Chapter 9 (commencing th Section 7000) I icenseffect. a Class: • • • • C License No Cb f T2 Z Dat 7' �� :... (QMRS' COMPENSATION DECLARATION ARNINd! FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALI DST OFtOMPErJS OV, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. i�reR$affirm uq jar pgnalty of perjury one of the following declarations: .. . . I ave and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Fmance of the work for which this permit is issued. Policy No. ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe urance carrier and policy number are: arrier Policy Number le of Agent certify that, in the p, . if I should become work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the letion, the Owner -Builder will have the burden of proving that it was not built or usiness and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). u prior to completion of the improvements covered by this permit, I cannot lega6, iderstand that a copy of the applicable law, Section 7044 of the Business and nfo.ca.gov/calaw.htmi. Date Division 3 of the Busine and Profession Code, and my license is in full force Contractor Signa re S AND CIVIL FINES UP TO ONE HUNDRE THOUSAND DOLLARS ($100,000), IN ADDITION TO THE Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date work for which this permit is issued, I shall not employ any person in any manner o as to become subject to a workers' compensation laws of California, and rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi ona. _ a nature of Applicant CLARATION REGXRDINOCONSTRUCTION LENDING AGENCY >reby affirm underrpenalty of perjury that there is a construction lending agency for the performance of the work for which 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 coun ordinances and state laws relating to building construction. I authorize representatives of this city or county t enter th ove-identified property for inspection purposes. mature of Prooertv Owner or Authorized Agent. Print Property Owner's or Aut ACT70N I DATE PERMITCANCELLED PERMITEX END€D PERMITFINAL CERTIFICATE OF UCLLHrfFt rIV19 Ut-l:Ulltli"f.lH1M4CY FEDERAL REGULATIONS PART 61 AQMD RULE 1403. ❑ ISUBINITEDASBESTOSTOT ❑ EPA ❑ AQMD ❑ ASBESTOSNOAFICANON15, dti PROPOSED DEMOLITION. SIGNATURE: permit is issued (Section 3097, Civil Code). TO. APPLtCABL.E 70 -T«-41 note /I 17r