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Home My WebLink About101 Main St - CofO (41)Q/ No.067783 ®I �d CITY OF HUNTil�iGTON BEACH DEPARTMENT OF 2000 MAIN ST. ail COMMUNITY CAE EL P HUNTINGTON BEACH, CA 92648 (714A NT )536.5241 ALL INSPECTION REQUESTS MUST BE RECEIVED BY 3:30 P.M. FOR THE FOLLOWING DAY'S INSPECTION.. PLUMB ING PERM IT Permit Number: P-016408 Bldg. Permit: B-039631 RC # 29 RD #461 Bldg. Address: 1.01 MAIN 109 Tract: NA Lot: NA Block: NA EXIST. BLDG. Buildsng Use: COM -- Contractor: Owner: CUESTA CONSTRUCTION CO HAAGEN-DAZS ICE CREM 3400 W WARNER AVE B WHAKDC, INC SANTA ANA CA 92704 Ph. 557-5877 Classes: 91 Ph. ( )557-5877 St.No. 568466 City Lic. A160438 Rem}..-ks: TENANT IMPROVEMENT (OWNER, W.H.A.K.D.C.,INC) --- Appl. Date: 05/13/94 Approved: TK ---------------------- ------------- Issued: 06/07/94 ECD #P--016408 Released: 06/07/94 ECD ----------------- ----------------- INSPECTION FEES Y Description pt Amount Description aty Amount _____----------- _-- ------ ----------- 3 24.00 Dishwasher 1 8.00 Kitchen/$ -ink Disp. 3 24.00 Water Distribution 4 30.00 Floor/Sink Drain --------------------- -------- ------ PERMIT FEES DESCRIPTION p'MOUNT ACCOUNT DESCRIPTION AMOUNT ACCOUNT INSPECTION b,1;L00 RAACD23430700 ISSUANCE 20.00 00 RAACD23430700 PLANCHECK 37..60 RAACD23430700 PENALTY 0.00 RAACD23430700 PC CD297269 15.00 ** PAID ** WATER FILTER 8.TOTAL FEE 151.60 Issued: 06/07/94 ECD #P-016408 Released: 06/07/94 EC` OWNER -BUILDER DECLARATION it CERTIFICATE. OF EXEMPTION FROM WORKER'S COMPENSATION INSURANCE 5 the 1031,5) Business and Professions Code: Any OiIY y toeits issuance, also requires a uires the applicant (This Tcertilq that tion ire the perft be ormance oft the vrorktforfor whine hundredp ermit do ar issued,)) rlshall ss.) employ any I hereby affirm that am exempt train the Any city 0, License Law for the nalkPerm reason. ((Sec. person In arty manner so as to become subject to Worker's Compensation Wws. alter, improve, demolish, pr repair any sfmpture, p Worker's Canl tor. such permit to life a signed statement that he is licensed pursuant to the provisions of the Date ( Confraclpes License Law (Chapter 9) (commencing with Section 7000) basof Division 3 ill the must forihwnh comply with such prevision Business and Professions Code, or filet he is exempt I'�ff a lame s ;mts the applicant i+ NOTICE TO APPLICANT: If, after making this Certil'kate of Exemption, you should become subject to the Workers Compensation provisions of the Labor Code, youexemption. Any violation Of Section 7031.5 by arty applicant or this permit shall be deemed revoked, LICENSED CONTRACTORS DECLARA110N license is fn full fore and with I, as owner of lheDreparty, or my employees with wages as their sole compensation, will do the 1 hereby affirm at I m licensed and rovisio of Chapter 9 (commencing with Sectiun 7000J of t akciai�Pt n r structure la not property. or a ered folive hundred r Sae, (Seo.7044) Business and R-ofessfons Code: Divisfen 3 al the ustne s and Proc_ass s de. a tl y is Cess The Conimcicr's License Law does not apply (o an antes of property who builds or Lmproves thereon, License Number and who does such work himself Or through Ms own employees, provided that such improvements Date g :marl Is sold within one Contractor prate tonal capacity action 7051, Business ark) Professions Code). year of completion, the owner/builder will have the burden of proving that he did not build a improve I am exempt, from the flier cements as am t iicensetl architect a registered pmlesslonai are not intended or offered for sale. It however, the building or improve El engineer acting in my p Date for the purpose of sale Lie, or Reg. No. ❑ I, as ovmer of the property am exclusively conCodonstracting The with licensed contractors to construct the THIS BOX FOR. REGISTER vALIDATION ONLY pmlect. (Sec. 7044)Bus-newlho builds or tmP oyes (hereon, andwhocontracts for SuchoProl`ectsa with to an owner of pope, a con haclor(s) licensed pursuant to the CbntIacIOr'a License Law. B. g P.C.for this reason I am exempt under Sec_ Owner Date CONSTRUCTION LENDING AGENCY I hereby affirm thattheca is a constpiction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). 3158/93 7Jun94 001/12 $151.60 P016408 BUILDPERMI Lender's Name Lenders Add. 1 certify that I I eve d this application and s e at to bail In it f construct on,� arid• her by tauthcri.e. with all city rdin ces and Stale g mooned p arty for ct, 'c pu representatives I . .. ity n no the to WORKER'S COMPENSATION DECLARATION gna Applica or Ag I hereby alfirm that 1 have a certificate Of consent to salt insure, or a certificate of Worker's ompensatwn Insurance, ar a certified copy thereof (Sec. 3000. lab. C). % 7 [}�( ,( Co pan N®a 061 I 83 Policy No. ❑ Codified copy is. erehy famished. Cei if dpy i fie w' h the city building inspection depa mml Date , Applicant If work Is not commenced 180 days tmm date f is ue of this p it, or if work is abandoned for more than 160 days, this permit shall be null and void. WHITE COPY - INSPECTOR, BLUE COPY -COUNTY, CANARY aO re^TOOFR OFFICE, GREEN COP f -APPLICANT, PINK COPY -TREASURER FORM 140-Rew. 12169 _ ..