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HomeMy WebLinkAboutP2019-0312 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII PLUMBING Permit: P2019-0312 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 1 9. 0 3 1r. 2 Project No: 1957-2018 Permit Counter Phone (949)644-3288 Inspection Requests Phone(949)644-3255 Job Address: 1644 GALAXY DR Bldg: 1 Floor: Suite: INSPECTOR Description of Work: PLUM GASLINE TO BBQ/FIRE PIT Inspector Area: 3 Code Edit 2016 Legal Description: N TR 4224 LOT 44- Owner: NIX DAVID WLIVING TRContractor: OWNER/BLDIR Worker's Compensation Insurance- °®°°°° Address: 1644 GALAXY DR Address: DAVID NIX Carrier :' ° d I ° NEWPORT BEACH, CA 92660 REFER TO X2018-2453 Policy No: ° ° `o Phone: 949-637-0508- Phone: " Expire Con State Lie:O/B C 1 IssuedDate:10/31/2019 G^ Lie Expire: / 1 Bus Lip: Processed By �T� Lic Ex Dater ° ° ° c c .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 $0.011 Sewer: ' 0 $0.00 Plan Check: $0.00 Hydro -Mass Tub:O $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 Nose 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 INSPECTION Construction flours:. 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 require, the app'ticant 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). ❑ 1, 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 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 provements 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 frArovecl for the purpose of sale)... W111 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 y 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: Byl my signature below I acknowledge that, except for my ers nal residence in which I must have resided for at least one year prior to completion of the improvements coven by this permit, I cannot legally sell a structcre t)2t I have built as an owner -builder i t has of been ruct in its enti ety by licensed contractors. I understand that a copy of the applicable law, Secf n 7044 of the Business and Professions �odda; is available upon request when is app, f ubmitte or the f lowing Web site:http://www. leginfo.ca.gov/calaw.html. D e § 9g4ture of Pjppp.�ty Owner or Authorized Agent I t el • LICENSED CONT CTOR'ECL RATION • l bareby affirm Ander penalty of perjury that I am I�censed u r provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions ode, and my license is in full force .od effect. ' }icepse ClasC'... . License No Date Contractor Signature W$RRERS'Idb&UENSATION DECLARATION VPJV64G: FAILUp650aaCURE 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 OP COMPENSATION, -DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. literary affirm untler penalty of perjury one of the following declarations: .• 1 hive and, Ul.rBaintain 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 thr 5rnlance of the work for which this permit is issued. Policy No. haveand willl*m stain 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' compensation insurance carrierrandrpolicynumber are: ler Policy Number Expiration Date Ie of AgentPhone # certify that, in the perfor n e of thew hich this permit is issued, I shall not employ any person in any manner so as to become subject to le workers' compensation laws of California, and agre, If I should become sub' ct the rkers' colip nsation p ovlsiorys of Section 3700 of the Labor Code, I shall forthwith comply with those provisi ns. e/� iatureofApp licant �� Dat � % 7LARATION REGAING NSTRUCTION LENDING AGENCY �eby affirm under p natty o erjury that there is a construction lending agency for the performance of the work for which this permit is issued Section 3097, Civil Code). ier's Name'. Lender's Address ny 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 he rovided is correct. I agree to comply with all applicable city and count or �nanc �Stalekaws r sting to building construction.I authorize representatives of this city or county tD��th pr erty for inspection purposes. / FJ A �r ^ w / %3 / iature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name 4 iJ A/ X /te O/ � F AC➢ON DATE BY DECLARATION OF COMPLIANCE WITH CODEOF FEDERAL REGULATIONSPART6S OFTITLE40AND AQM➢RULE1403. ❑ I SUBMITFED ASBESTOS NOTIFICATION TO: ❑ EPA ❑" AQM➢ ❑ . ASBESTOS XOTI ICATI©NIS NOT APPLICABLE TO PROPOSEDDEMOUTION. SIGNATURE:. FOROFFICEUSED Y - PERMITEXPIRED — _ �PERMITCANC€LL€D PERMITFXTENDED PERMIT FINAL /L 2p2O CERT7FfCATE OF OCCUPANCYISSUED