HomeMy WebLinkAboutP2020-0037 - PermitsCity of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111111111
r- 100 Civic Center Drive, Newport Beach, CA 92660 P 2 0 2 0 0 0 3 7
,1 Permit Counter Phone (949)644-3288
Job Address: 1672 PEGASUS ST Bldg: 1 Floor: Suite:
Description of Work: PLUMB -GAS LINE TO BBQ
Inspector Area: 8 Code Edit 2019
Legal Description:
Owner: BERNARD KYLE
Contractor:
SWAN POOLS OF SOUTHERN CA
Address: 1672 PEGASUS ST
Address:
24512 BRIDGER ROAD
NEWPORT BEACH CA 92660
FEES
LAKE FOREST CA 92630
Phone:
Phone:
949.859-8466
Con State Lic:440333
Issued Date:02/20/2020
Lic Expire:
03/31/2020
Misc.
Bus Lic:
BT96008994
Processed By:
Lic Exp Date:
07/31/2020
PLUMBING Permit: P2020-0037
Project No : 2443-2019
Inspection Requests Phone (949)644-3255
Worker's Compensation Insurance -
Carrier : STATE FUND
Policy No:9228545
Expire : 04/01/2020
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.
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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
Lndryffrap:
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 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.
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OWNER -BUILDER DECLARATION -A
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 itel(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 issMance, also requires the appli •ant 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 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 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, I cannot Iegafi
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 Sec'on 7 0) of Division 3 of the Business nd Pr as ' In o and m 'beliBe is in full force
and effect.
License Class License No Da Contractor Signatu
NORKERS' COMPENSATION DECLARATION
VARNING: 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 AUDITION TO THE
30ST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 the
r
ce 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' compensatior
carrier and policy number are:
Policy Number
ie of Agent
certify that, in the pI
if I should become
Iature of ADDlicant ,
Date
issued, I shall not employ any person in any manner so as to become subject to the workers'
is of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �]
n�e�V �C�
hereby affirm under penalty�f perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sebtion 3097, Civil Code)
ender's Name Lender's Address
y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the arty owner's behalf.
I have read this application and the information I ave pro d is correct.
I agree to comply with all applicable city and count ordinanc to aws lati g to ilding construction.
I authorize representatives of this city or county jo/en r e -id tifie rop y Qt Inspection purposes.
nature of Property Owner or Authorized Agent int Property Owner's or AutnorizeD Agent's Na
ACTION DATE BY DECLARATION OF COMPLIANCEtMTH CODE OF
• • • • • • • • • , •
FEDERAL REGULATIONS PART 61OFTITLE40AND
PERMITEXPIREDi ••• • •• i • i AQMD RULE 1403.
❑- 1 SUSM/TFEDASBESTOS NOTIFICATION TO:
PERMITCANCELLED • • , •,• ••• ••• ❑ EPA
PERMIT EXTENDED ❑ AQMD
❑ ASBESTOS U077FICARONIS NOT APPLICABLE TO
PERMIT FINAt a "� • • • • ... PROPOSED DEMOLITION.
CERTIFICATE OF i •• •• i i a• i o
SIGNATURE:
OCCUPANCYISSUED �: _ • _ _ • • , ,
laws of California, and
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