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Home My WebLink AboutP2019-0127 - Permitsao City o0rnort beach Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII 11 PLUMBING Permit : P2019-0127 18QCivrc,CenIereDrric, NcW ort Beach, CA 92660 P 2 0 1 9 0 1 2 7 Project No: 0613-2019 Perna Coo*test *06e (94£3)6.34-3288 1 Inspection Requests Phone (949)644-3255 , 9 e e ose e Job Address:* 1358 • St9S3EX L•N Bldg: 1 Floor: Suite: Description of Work: PLMB - GAS LINE TO FIRE PIT (X2019-0900) Inspector Area: 3 Code Edit 2016 Legal Description: N TR 1896 LOT 55 Owner: BRIGGS BRYAN Contractor: ROMAN CONSTRUCTION Address: Address: P 0 BOX 1146 FEES WALNUT, CA 91788 Phone: Phone: 909-229-2099 Con State Lic:971274 Issued Date:04/24/2019 Lic Expire: 10/31/2019 Misc. Bus Lic: BT30066707 Processed By: Lic Exp Date: 04/30/2020 Worker's Compensation Insurance - Carrier : EVEREST Policy No:7600019437181 Expire: 09/16/2019 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: 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: $0.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $10.00 Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 Additional Fee: $0.00 TOTAL: $17.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $17.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. OWNER -BUILDER DECLARATION'•, I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s ;I have p:scttd uerQ io thr9pplicable items) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, p%r2o ity :;s6$rte!alao mquiresthe 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 Sivision 3 8f411e 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). • a , , ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is nqt intended Or olfer4pd jor%aLe (Seltioq 7x44, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effortf 6uilds2r improM the VropeAApravi4d 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 69ve'the burden of proring that it vAj tot built or improved for the purpose of sale). ❑ 1, 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, 1 cannot legall) 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 700"�0) of Division 3 of the Business and P o ssio Code, and my license is in full force and effect. . Z T ^ Contractor Si License Class License No Date gnat WORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED ThOtMAND DOLLARS ($700,000), IN ADDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penally of perjury one of the following declarations: 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 ice of the work for 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' compensa carrier and policy number are: Policy Number Date is of Agent I r'none s certify that, in the performanc of th wo or whic this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and if I should becor�//9J,,,e ubject to or compo ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 6 G� Iature of ApDIICaZt, Dato2z, hereby affirm under penalty of perju hat they is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code) Ender's Name Lender's Address ly 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 pro d i oIT I I agree to comply with all applicable city and county or ' cos J stat laws relating to building construction I authorize representatives of this city or counjy to e r ie abo - I' r rr Rspection purposes. �^�� &3 _ I :innafure of PmnRrtv Owner nr Authnrized Anent i(1 Print Prooertv Owner's or Authorized Aoent's Name H f- �_.V� ACTION I DATE PERMITFINAL CERTWICATEOF OCCUPANCYISSUED FEDERAL REGULATIONS PART 61 OF TTTLE40AND AQMDRULE ?403. I SUBUTTEDASBESTOS NOTIFICATION T0: ❑ EPA AQMD ❑ ASBESTOS NOTIFICATION/S NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: