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Home My WebLink AboutE2019-0147 - Permits0 City of Newport Beach - Building Division 11J111 11111111111111111111111111111111111111111111111 it 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 1 4 7 Permit Counter Phone (949)644-3288 Job Address: 1201 DEVON LN Bldg: 1 Floor: Suite: Description of Work: ELEC/INSTALL 80 AKMP SUB -PANEL Inspector Area: 3 Legal Description: N TR 3000 LOT 68 0 Owner: RASCH STEPHEN WILLIAM Contractor: Address: 1201 DEVON LN Address: NEWPORT BEACH, CA 92660 0 Phone: 949-722-8902 Phone: 0 Con State Lic: Issued Date:03/13/2019 Lic Expire: ( Bus Lic: Processed By: \_ Jr 'Y Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0 $0.00 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $61.00 HOLLAND CUSTOM BUILDS 970 GOVERNER ST COSTA MESA CA 92627 949-870-5871 1036760 03/31/2020 BT30064433 09/30/2019' Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs 10 to 50 HP/KW/KVA: 0 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 Electrical Permit: E2019-0147 Project No: 0390-2018 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: NO EMPLOYEES Policy No: Expire FEES 0 $0.00', Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee : Temp Underground: 0 $0.00', Sub Panel: 1 $26.00', 0 $0.00' o $0.00 Record Mgmt Fee: $0.00'. Plan Check Fee: $0.00 Investigation Fee: $0.00'. Issuance Fee: $35.00 Supplemental Fee: $0.00' Fee Due at Permit Issuance: 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 6Y• 1 • W i • • 44 i • • ` e E L mo a. • • a.° ' •ao °•` o�c s o coo cc e s c ° o m • wo« ••o •oa •••• •°o )WNER-BUILDER DECLARATION 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 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 is 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 'rofessions 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 penally of of more than five hundred dollars ($500). 7 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 nprovements 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 nproved for the purpose of sale). 1 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 pply 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). I I am exempt from licensure under the Contractors' Slate License Law for the following reason: ly.. 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 legally ell 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 'rofessions 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 Dale .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prolfgssle Code, and my license is in full f c nd effect. ` icense Class License No Date 1i 331a// 9 Contractor Signature - -- VORKERS' COMPENSATION DECLARATION / IARNING: 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 ADDITION TO THE OST 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: 7 1 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 erformance of the work 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' rance carrier and policy number are: 'ier Policy Number Expiration Date me of Agent Phone # �bertsfy that, in the performance of the work for which this permit is issued, I shall no mploy any person in any manner so as to become subject to the workers' compensation laws of California, and agree C if I should become subject subject to the workers' compensa'e r6visi on 3 of the Labor Code, I shall forthwith comply with those provisions. (nature of Applic2 i��iL D�9 ICLARATION REGARD STRUCTION LENDING AGENCY ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider's Name Lender's Address 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. I agree to comply with all applicable city and county ordinances and state laws I authorize representatives of this city or county tVb eptt9a;e,above4dent' 'eql ACTION I DATE I BY PERMITEINAL CERTIFICATEOF OCCOPANCYISSUED to building construction. Ispection purposes. Print Prooertv Owner's or Authorized .FEURAL REGULATIONS PART 61 OFTBLE40AND AQ bR1JLfh4033,e '.❑ `•I SgBWT%ED2ISBESJO9W7WICATIONTO. E3 SPA ❑ AOND • •• [3ASBESTOS NQRACARQNIS NOT APPLICABLE TO • pbj:0•POSEDDEMOLITION.