The URL can be used to link to this page

Home My WebLink AboutE2018-0694 - PermitsCity of Newport Beach - Building Division ;- 100 Civic Center Drive, Newport Beach, CA 92660 F 'y Permit Counter Phone (949)644-3288 �'s+tcosa�v Job Address: 719 1, Description of Work: Inspector Area: Legal Description: IRIS AVE Bldg: 1 Floor: Suite: ELEC/DISCONNECT TO A/C H2O18-0663 Owner: LONG ROBERT Contractor: Address: 719 IRIS AVE Address: CORONA DEL MAR CA 92625 Phone: Phone: Con State Lic: Issued Date:10/19/2018 Lic Expire: Motors/Transformers (HP/KVA) Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2018-0694 E 2 0 1 6 0 6 9 a Project No: Inspection Requests Phpng (949)644-3255 Code Edit: 2016 L;w OP ROHAN JOHN MARK Worker's Compensation Insurance 31845 VIA FLORES Carrier: SECURITY NATIONAL SAN JUAN CAP CA 92675 Policy No: SWC1145938 949-310-9388 Expire : 03/04/2019 ° 597158 06/30/2020 BT30056894 10/31/2018 u°°eoe r °e c o o eeeoo )OUf O 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. FEES e.Y.c Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) O O O O Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $psw $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: °a° °6 $0.<00.= $0.00 Sep Circuits: 1 $7.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Backfremp Power: 0 $0.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 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. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 requires the applicant 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 U 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 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 imp roved for the purpose of sale). ❑ I, 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 a- 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). ❑ I'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 legal 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.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm wider penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr salons od -a + y license ''; in full force and effect. . AA _ R_� c.icow*Class .... License No Dat /y ContractorSignatur WORARS' dOMPASATION DECLARATION WARNING. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS'UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TO ONE HUNDRED H S ND DOL S ($100,000), IN ADDITION TO THI COSTUP COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. % I he re* affirm ender penalty of perjury one of the following declarations: 'have and vwll majntain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provid or by Section 3700 of the Labor Code, for tl Mpnce oftq%%V9dk for which this permit is issued. Policy No. have 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' compensati< sure IS carrierand policy number are: to' .Arrier' 00'00: PolicvNumber Expiration Date ie -61 Agent . ., rnonea .. . . certify that, U? thlb'performaijce of th o whit t ' p it is issued, I shall not employ any person in any manner so as to become subject to the workers' , if I should become subj to th o rs cc pe ation visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. lature of Applicant Date �reby affirm under penalty of oeFifiry at there i�fa construction lending agency for the performance of the work for which this permit is issued (Section ider's Name - /� Lender's Address my signature below, I certify each of the following: I am the property owner or authorized to act on the property Ow is behalf. I have read this application and the information I have provide Is correct. I agree to comply with all applicable city and coun ordin a ' n e I authorize representatives of this city or county enter the -i if' nature of Prooertv Owner or Authorized Aoent ACTION I DATE I PERMITExPIRED I I l/ 1 PERMITCANCEttED PERMITEXTE VDED ( /� OCCOPANCYISSDED to building construction. Ir inspection purposes. Name ❑ I SUOM ITEDASBESTOS N077EICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS M017RCATIONIS NOT APPLICABLE TO PROPOSEODEMOUTION SIGNATURE. FOR California, and l _/Hg IR_)