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HomeMy WebLinkAboutP2019-0319 - PermitsCity ofoenter NewoportriveTh, NewportachBuilding Division IIIIII�II�II�IIIIIII�II�9���I�I�II�II�IIIIIII�I PLUMBING Permit: P2019-0319 �- Permit Counter Phone 949 644-3288 I Project No : 1608-2017 Inspection Requests Phone (949)644-3255 Job Address: 313 FULLERTON AVE Bldg: 1 Floor: Suite: Description of Work: PLUMB - GAS LINE Inspector Area: 2 Code Edit 2016 Legal Description: FIRST ADD TO NEWPORT HEIGHTS BLK 18 LOT 17 Owner: HARDEN GUY Contractor: OWNER/BLDR Worker's Compensation Insurance - Address: 313 FULLERTON AVE Address: Carrier: NEWPORT BEACH, CA 92663 Policy No: Phone: Phone: Expire Con State Lic:O/B Issued Date:11/12/2019 Lic Expire: Bus Lic: Processed By: Lic Exp Date: N1 - U I Uri 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: 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: $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: $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: $42.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $42.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSP CT70N 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. 00 00(3 0 1) 0 119113 13110 0110 O U O 0 U O 00 J ® 0 O O O O O 4+3 0 V OQ OO VO U 0 O O O 00 fi0^J �3 O � 000 U O O U O O O U J O O O O 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) 1 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 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 safe).' T-Is owner of the property,llam exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not )EB�ymy o an owner of propertywho builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). m exempt from licensue'under the Contractors' State License Law for the following reason: ignature below I acknov✓ledge that, excep01" sonal residenc in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally a structure that I have built as an owner-b en co ructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and essions Code, is available',upon requestH . u or at the following Web site:http://www.leginfo.ca.gov/calaw.html. (1 , i 2 Signature of Property Owner or Authorized Age Date 1 t t ! l LICENSED CONTRAC OR'S 6ECLARATION I hereby affirm under penalty,lof perjury that 1 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. License Class License No Date Contractor Signature WORKERS' COMPENSATIONDECLARATION 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS,PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of,pedury;one of the following declarations: ❑ I 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 th performance of the work for which !this permit is issued. Policy No. ❑I have 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' compen insurance carrier and policy number are: Policy Number Expiration Date Name of Agent Phone # ❑1 c rtify that, in the perform of the work for w ' h 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 th , if I should become sub' $ E Morn a sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Z Signature of Applicant Date_ Ate. DECLARATION REGA DI G' bNST CTION LENDING AGENCY I hereby affirm under penalty' of, perjuryat 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 I 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 provi ed is correct. I agree to comply with all applicable city and county or n and state law tlating to building construction. I authorize representatives of this city or county, en r`t a d roerty for inspection purposes. Authorized Agent17IPrint Property Owner's or Authorized Agent's Name I /i I'i L _ Date 2i i Signature of Property Owner or g Pi•cR FT D(PIRED c, c- PERIVITtANCELLED I PER-&1,71TS<T1 ENDED I I I RFAIT.;FINAL/ �If ` r;'F- P r r Lr��: FYE,'OCCUPANCYISSUED - r FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMDI LE 1403. (] I SUBMITTED ASBESTOS NOTIFICATION TO. - EPA AQUD © :ASBESTOS M077HCA170NIS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE., FOR OFRCE USEONLY