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Home My WebLink About1121 PARK - CofO�4 Me CITY OF HUNTINGTON BEACH laki 2000 MAIN ST. HUNTINGTON BEACH, CA 92648 PLUMB ING P E R 11 I T C3o020250 DEPARTMENTOF COMMUNITY DEVELOPMENT Y.O. BOX 190- CALIFORNIA 92648 (714) 536.5241. Z Permit Number: P011453 PC # RD #441 ! Bldg. Address: 1121 PARK Tract: NA Lot: NA Block: NA EXIST. BLDG. Building Use: SFD ; Owner: Contractor: DON MC ALLISTER REL VROOMAN PLUMBER SAME 914 OLIVE HUNTINGTON BEACH CA 92648 Ph. ( )969-6714 St. No. 5&4518 C36 City Lic. A095570 Comments: CAS PIPING ------------------------------------------------------------------- ^------------ Appl. Date: 03/19/91 Approved: ---- --- -------------------- ---------------------------------- Issued: Gli(: 03/20/91 Permit/Receipt # P-011453 ----- ------ - INSPECTION FEES R Description Qty Amount Description Qty Amount - Gas Piping < 6 1 5.50 Gas Piping >_5 2 2.50 --------------------------------------------------------------------------------- PERMIT FEES DESCRIPTION AMOUNT ACCOUNT DESCRIPTION AMOUNT ACCOUNT _ __ _ ----------- ----- -------- INSPECTION 10.00 RAACD23430700 PROCESSING 10.00 RAACD23430700 t PLANCHECK 0.00 RAACD23430700 PENALTY 0.00 RAACD23430700 TOTAL FEE 20.00 j{ 9a Issued: GHG 03/20/91 Per•rit/Receipt P-011453 CERTIFICATE 01P EXEMPTION FROM WORKER'S COMPENSATION INSURANCE OWNER -BUILDER DF-CLARATiION (This secilon need not be completed it the permit Is for one hundred dollars (5900) or less.) I. hereby affirm that ! am exempt from the Contractors LicCnSe Law for the following reason. ` - - I certify that in the performance of the work I:r which this permit is issued. I shall not employ any person in t(Sec. 7031.5) Business and Professions Code: Any city or county which requires a permit eny manner so as tobecome subject to Worker's Compensation Laws to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also Dale Applicant requires the applicant for such permit to file a signed statement that he is licensed NOTICE TO APPLICANT. It. after making this Certificate of Exemption, you should become subject to the pursuant to the provisions at the Contractor's Vzonse Law (Chaplet 9) (commencing with - Worker's Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or Section 1000) of Division 3 of the Business and Professions. Code, or that he is exempt r this permit shall be deemed revokedtherefrom and the b3srs for the alley -of exemption Any violation. of Section 7031.5 by any .LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 fcommencmg with Section 70001 of Divi!r.on applicant for a period subjects the applicant to a civil penalty 01 not more than live 3 of the Eusiness and Professions Code, and my license is in full force and effect hundred doltars. ($500).1. a License Number Ltc Class ❑ I, as owner of the property, or my employees with wages as thou sole compensation. Conlractgr Ozte will do the work, and the structure is not intended or offered for sale. (Sec. 7044) I am exempt from the licensing requirements as I am a licensed architect or a registered professonal Business and Professions Code: The Contractor's License .Law does not apply to an owner ❑ engineer acting in my professional capacity (Section 7051. Business and Professions Cadej . of pro('?rty who builds or improves thereon, and who does such work himself at through I.ic. 0, Reg. No.. Date.. his own employees, provided that such improvements are not intended or offeredfor safe. It. however, the budding or improvement is sold within one year of completion, the THIS BOX FOR REGISTER VALIDATION ONLY ownerlbuilder will have the burden of proving that he did not build or improve for the purpose of sale _. ❑ 1. as owner of the property. am exclusively contracting with licensed contractors to construct the project. (Sea 7044) Business and Professions Code. The Comractnr's License Law does not apply to an owner of properly who builds or improves Ihereoii, and who contracts for such projects with a contractortsr licensed pursuant to the Contractor's License Caw, ❑ I am exempt under Sec. B & P.0 for this reason D.19/2 Cairo" 0�i / O,A ., Q� O -.i 3�3c@cS"^;�j.7.v�'T Owner x.` CONSTRUCTION LENDING 4OENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued fSec 3097 Civ C t Lender's Name Lenders Address WORKER'S CGMPENSATION DECLARATION I Cori,[) that I have read this application and state trial the above information is correct. I hereby affirm that t have a certificate of coh! ellmsure. or a certificate of Workers Compensation it zuiance. i agree to comply with all city ordinances and Slate aws relating to building construction. or acen4ied copy thereof (Sec 3800. L and hereby authorize representatives of this city Yo enter upon the abov„ mentioned properly Poly Np ,._ Com for inspection purpuses ❑ Cc�*ed cop),s here rmsn ^' C-4 :ied Copyi. •d.11,1 city bwiong mspe do an -an Signature of Applicant or Agent J Date Date APP. OD . 02 0 2 5 0 If W rk is not min Ed 180 days ate of A sue of this permit, or it vidik is abandoned for more than 18 ays, this permit shall be null and voi WHITE COPY INSPECTOR, BLUE COPY - COUNTY, GOLD � /Ct� rP!�yY�•�-+IOpFFpICE, GREEN COPY - APPLICANT, PINK COPY - TREASURER PORC( 140 Rev itB9. 1rit�d'9"e:.O.Ar OR