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Home My WebLink AboutP2018-0377 - Permitstr City of tNevpprt•peach e Building Division hIIIIIIIIIIIIIIII!lIIIIIIII�IIIIIIIIIIIIIIIIIII PLUMBING Permit: P2018-0377 100 Civic CTter lkive,eNewp)48e,�h, tdA m 2660 P 2 0 1. 8 0 3 7. 7 Project No: `.� Hermit Counter Rho,,e 41* 1:44."8 m - "�s#eoeo Inspection Requests Phone (949)644-3255 ® o e e e e eo a e • • ® 'em e Job Address: 311 MARINE AVE •fIdg: 1'Ploore e e • Cuite: Description of Work: PLUM/INSTALL (2) GREASE INTERCEPTORS @'ROYAL HEN' *SEE EXP P2018-0131• Inspector Area: F Z Code Edit 2016 Legal Description: BALBOA ISLAND SEC,4 LOT 31 ELK 13 W 75 FT Owner: CHUEH DANIEL Contractor: OWNER/BLDR Worker's Compensation Insurance - Address: 311 MARINE AV Address: SHAFER CYNTHIA Carrier: BALBOA ISLAND CA 92662 Policy No: Phone: Phone: Expire Con State Lic:O/B Issued Date:11/14/201 Lic Expire: Bus Lic: Processed By: Lic Exp Date:IM ', r 1. 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:2 $56.00 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 Lndryrrrap: 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 : ($28.00) TOTAL: $63.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $63.00 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 cljeckl*r4s); have pieced nwd 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 aay etre ctereeigrforto.9s %%Cans®,•also requrms 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 (cAtnencing with Section 7000) of Division 3 of the business an`d 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 U portions of the work, and the s1recturD1s got,Intendetl orvfferre d for2;ale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or persona0effort, Qdirds oe 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 Owft-tuilriar will (rave thL•Uurderf df'prdving that it was not built or improved for the purpose of sale). 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 nct 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). exempt from licensure under the Contractors' State License Law for the following reason: $y' y ignature below I acknowledge that, except for my personal residence in which I must h ve resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal], a structure that I have built as an owner -builder if it has not been constructed in its an i ty by licensed contractors-) understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request wh n his application is a, ted or at the flowing Web lte:htlp://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent ✓In N ! t LICENSED CON C OR EC RdT10N j ! I hereby affirm under penalty of perjury that I am licensed under pr vi iop5 of Chapter (bommencing with Section 7000) of Division 3 of the Business and Profession e, and my icense is in full force and effect. // License Class License No Date Contractor Signature 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 THOUSAND DOLLARS (§700,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury 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 erformance of the work for which this permit is issued. Policy No. have and will rhaintain 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' rance carrier and policy number are: Policy Number Agent Date ]I 4 that, in the performance of the work for which this pe Cis issued, I shall not employ any person in any manner so as to become subject to the workers' compen Ia , if should becom u ject to the wo/r/kers' compensation rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant^'/ - i L gate iECLARATION RE DIN CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury�that there -i's, �a�constructfon lending agency for the performance of the work for which this permit is issued (Se ion 3097, Civil Code). enders Name "/ Lender's Address y my signature below, I certify tote ch 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 ordinances and state Is I authorize representatives of this city or county tp tinter the/dbove-identifiec ACTION I DATE PERMIT FINAL CERTIFICATEOF OCCUPANCYlSSUED relating to building construction. operty for inspection purposes. Print Prooertv Owner's or Authorized Aaent's Name FEDERAL REGULATIONS PART 61 OFTITLE40AND AQMD.RULE 1403. ❑ /SUBMITTED ASBESTOS M077FICATION TO: EPA ❑ AQMD ❑ ASBESTOS NOIIRCARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: laws of California, and '114AW 41