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Home My WebLink AboutE2017-0620 - PermitsCity of Newport Beach - Building Division o 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 921 CLIFF DR Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE Inspector Area: Legal Description: N TR 1218 LOT 96 Owner: MASLINATI MANNAWI Address: 25376 PACIFICA AVE MISSION VIEJO, CA 92691 Phone: Issued Date:12/04/2017 Processed New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 *E2017-0620* Contractor: BAYLESS JEFF ENTERPRISES Address: 111 DIJE CT UNIT C FEES SAN CLEMENTE, CA 92672 Phone: 951-830-6264 Con State Lic: 371092 Lic Expire: 10/31/2018 Bus Lic: BT30053918 Lic Exp Date: 02/28/2018 Electrical Permit: E2017-0620 Project No : 2686-2017 Inspection Requests Phone (949)644-3255 Code Edit: 2016 A N S I E V I ®1 l Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9092149 Expire : 03/11/2018 e a o Plan Fee Due 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'"-"• ° Receptacle/Switch/Outlets Motors/Transformers•e•• (HP/KVA) •• Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0000 $9.00— $0.00 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.100— $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 ` 0 4.1110o ° Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 m • • • 4le $0.00 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: ° `• • $0.66-0 $0.00 Each Add Circuit: 0 $0.00 Piggy Backrremp-Power: 0 $0.00 Investigation Fee: • $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $36.00 Issuance Fee: $33.00 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 Plan Fee Due 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. 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 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 notintended 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 im roved for the purpose of sale). 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 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 License Law). ❑ 1 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.htm]. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commen 'ng with coon 7000) of Division 3 o the Business and Prof ssions Code, and my license is in full force and effect. CAM License Class License No D e Lk --Ii Co racto ignature RS' COMPENSATION DECLARATION / 'AILURE 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 T )MPEN9Ar M!r=AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ffirm udder g%nalty of perjury one of the following declarations: and* ma ntain 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 Cade, for Ice of the work for which this permit is issued. Policy No. and vyill Trtafrtain 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' compensa carrierandyolicy number are: .... Policy Number Expiration Date p.& Agent — ei*fy that, in The if rshould,bboiarf the work for which this permit is issued, I shall not employ any person in any manner so as to become subje t to the workers' compensation laws of California, and agre workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr Islons. I� D > MSRA REGARDING-CbNSTRUCTION LENDING AGENCY Ireby affirmder 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 T 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 nces and state laws relating to building construction. I authorize repres tati s of this city, or county to n r bov -identified property for inspection purposes. G( _S r _ nature of Propert O er or Authorized Agent Print Property Owner's or Authorized A ent a h.G( lD ACTIO DATE B DECLARATION OF COMPLIANCE IMTH CODEOF FOR 01 11 FEDERAL REGULATIONS PART 61 OFTITLE40AND �2-LL+ AQMDRULE1403. PERMIT EXPIRED ❑ I SUBMITFEDASBESTOS NOTIFICATION TOr ❑ EPA ❑ AQMD PERMIT CANCELLED PERMiTEXTENDED ❑ ASBESTOS N07IRCA770NIS NOT APPLICABLE TO PERMITFINAL /o f PROPOSED DEMOLITION, SIGNATURE: CERTIFICATEOF OLCUPANCY)SSUED �2-LL+