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Home My WebLink AboutP2019-0111 - Permits,�vr City of Newport Beach - Building Division 100 Civic Vente, bri�re, Neavportdieach OA 92660 y Permit Cotnter i5bor a (U40)6d4-M88 e .m• . . • ••. •. ""errfu�� Job Address:549 S°RAWAfDRD:•BldgylFlo®r.• •®`Suite: Description of Work: PLUMB - GAS LINE TO BBQ, SINK Inspector Area: 5 Code Edit 2016 Legal Description: N TR 1237 LOT 105 Owner: ESTRADA ORLI AND JUA Illlll�F�llll0llu�l�ll��lll0ll��lll��l��lllll N Contractor: FREE CREATION INC Address: 549 SEAWARD RD Address: 5478 WILSHIRE BLVD UNIT 214 CORONA DEL MAR, CA 92625 Phone: LOS ANGELES, CA 90038 Phone: (323)879-9060 Issued Date:04/11/2019 Con State Lic:1003352 Lic Expire: 05/3112019 Processed By: Bus Lic: ST3005822 Lic Exp Date: 04/30/2019 PLUMBING Permit: P2019-0111 Project No: 2954-2016 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance Carrier: MIDWEST Policy No:BNUWC0141655 Expire : 09/14/2019 Bathroom Fixtures FEES Kitchen Fixtures Misc. Toilet: 0 $0.00 Kitchen Sink: 0 Misc. Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Roof Drain: 0 `T Other Urinal 00 0 $0.00 Bar Sink: 1 $0,00 Grease Trap: qR $0 011 0 Bath Tub: 0 $14.00 Water Heater. 0 $0.00 Grease Intercept r.0 ' ,Q00 '.. $0.00 Ice Maker: Sink: 00 $0.00 Gas up to 4 outlets: 7 $7.00 P-Trap Shower Stall: 0 Wash Basin: 0 $0.00 Gas over 4 outlets: 0 $0.00 Sewer ,.0.00 Record Mgmt Fee: Hydro -Mass Tub:0 $0.00 LDnd lrraer 0 $0.00 Backflow up to 2": D $0.00 Sewer. ` Investigation: Floor Sink: ' 0 ryp $0.00 BackOow over 2": 0 $0.00 0 $0.00 Plan Check: $0.00 Regulator: 0 $0.00 Hose Bibb: SewerAlter7Repair.0 $0.00 Issuance: Floor Drain: 0 $0.00 Lawn Sprinkler: 0 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $0.00 Drinking Fountain: 0 $0.00 Additional Fee : TOTAL: $56.00 $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance $56.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VAL O IN 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. $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 •. ••Y 1 • •- .• ••O OWNER -BUILDER DECLARATION lotto is s ace, DIED requires the applicant for 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 o�reekmarQ.(s; I �ave.piacetl nex4'to thelcantllo alcive penalty of (Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair anm"Iatntor permit suti a is thapp' the permit to filede nigned or that herement that o she is exempt from I he or she is licensee and cant to he the provisions sions allegedexemption.thmonoctor violation Li of Section 7031.5 by any P6nd11hJwItMSectib: 7080) DFprvls on 3 of the Business and Professions Co ) • ! Section 7044, not more than five hundred dollars ($500). all of or (_) portions of the work, and the s*uoture �9n *t in itis or Jn r6vred�eror ole (Section provided that the ❑ 1, as owner of the properly, or my employees with wages as their sole compensation, will do (_) d(,w %,t• %Q� Q Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, buiQis or Qnp Q�Q Q of c ement is so improvements are not intended or offered for sale. If, however, the building or impro construct the p oId ljed (Sectionthin one 7044 Businessompleandand Professions Code: TheContractors'State License Law does nproving that it was not ot improvedr improved for the purpose of sale). ❑I, as owner n the property, am exclusively contracting with licensed Contractors to 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 LicenseLaw).y I cannot le all! applicable law, Section 7044 of the Business and (iORKERS'COM I am exempt from licensor under the Contractors' State License Law for the following reason: 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 theim rovemenDatethis perml ,rety by ellaProfstructuresions th t I have bu as an upon requestbwhenrthis applcat onif it has not es subm tted or at the fon constructed in its lllowing IWebssitehttped r/ cfwww.legnfo.ca gov/calaw.html erstand that a COPY ofthe app'ignature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section�0OO� f DivisiCnOr3r�ctor S'gnat ss and Professions C ,and my license is in u orce and effect. 6 Date y�—cense ClassLicense NoPENSATION DECLARATION CCAOON CDAMAOES AS PROVOMPENSATIDED FOR IN SECTION ION COVERAGE7a8 OF THE LABOR CODE, INTEREST, AND ATTORNEY 'n EESRIMINAL PENALTIES AND CIVIL FINES UP TO ONE MU ED THOUSAND DOLLARS (E700,000(, IN ADDITION TfOr t URE I hereby affirm under penalty of perjury one of the following declarations: issued b the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, I have and will maintain a certificate of consent to self -insure for workers' compensation, y for the performance of the work for which this permit is issued. My workers' compensati ormance of the work for which this per is issued. Policy No. I eve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, Expiration Date s nce carrier and policy number are: policy Number Phone # Carrier Name of Agent I certify that, in the performance of the work for w anis on erovlis lies of Section113not 700 ofthe Labor in any mariner so as to h II forthwith complybwith hose pecome rovisions. onto s. workers' compensation laws of California, an a that, if I should become subject to the workers' Da Signature of Applican DECLARATION REGARDING CONS TION LENDING AGENCY Lender's Address I hereby affirm under penalty of ry that 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 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 provided is correct. building I agree to comply with all applicable city and county ordinances and st, ied we fforelating rinspect on purposes n Date I authorize representatives of this city or county to enter the abov property y print Progeny Owner's or Authorized A ent's Na a rnn ncnrAtESE DNLY ACT70N DATE � 6Y ❑ € SUBh7ITTEU ASBESTOS NDT7FICATION '• ❑ EPA ^ ❑ A4MOAinTIncal7ONIS NOT APPLICABLE TO CEftTIFfCATE OF SIGNATURE: OCCU.PANCYISSUED