HomeMy WebLinkAboutE2018-0190 - PermitsCity of Newport Beach Building Division11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII JillElectrical Permit: E2018-0190
o 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 8 0 1 9 0 Project No: 1720-2017
F S Permit Counter Phone (949)644-3288
r r Inspection Requests Phone (949)644-3255
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Job Address: 15 DEERWOOD LN Bldg: 1 Floor: Suite:
Description of Work: ELEC A/C DISCONNECTS
Inspector Area:
Legal Description: N TR 7638 LOT 101
Owner: DEERWOOD LLC
Contractor:
Address: 20151 SW BIRCH ST STE 150
Address:
NEWPORT BEACH, CA 92660
Phone: 949-250-4200
Phone:
Con State Lic:
Issued Date:03/21/2018
Lic Expire:
New Construction
Bus Lic:
Processed By: 6DL�
Lic Exp Date:
WATER MILL HOMES INC
20151 SW BIRCH ST #105
NEWPORT BEACH, CA 92660
949-250-4200
941819
01/31/2020
BT30034736
08/31/2018
Code Edit: 2016
Worker's Compensation Insurance
Carrier: STATE COMP
Policy No: 1606900
Expire: 01/01/2019
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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
New Construction
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
0
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
1
$25.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
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
Service
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$33.00
0/H to U/G
0
$0.00
Additional Fee:
$0.00
Supplemental Fee:
$0.00
TOTAL
Fee :$58.00
Plan Check
Fee: $0.00
Fee Due at Permit Issuance:
$58.00
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 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 9y(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 7831.5 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 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
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 net
ffap ly 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 am exempt from licensure under the Contractors' State License Law for the following reason:
By my signatyr'@b4!ow 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
sell a structuretM l 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
P4gf%4sions Code, ie: available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
SignatLre of FPj96arW Owner or Authorized Agent Date
EICL!gSED CONTRACTOR'S DECLARATION
I ITareby affirm yndet penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business a Professions ode, and my license is in full force
and affect. • • - n
LiCW8 Class * 4 License No Date / /7l Contractor Signat
WORKERS' cbmiaiNSATION DECLARATION
pFAILURE SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN YES TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OF
COST OF COMPENSATITi ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Leo
affirm V:qe penalty of perjury one of the following declarations:
e 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 thnce of,)Rawork for which this permit is issued. Policy No.
. 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' compensatio
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
I certify that, in the perforpance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to theworkers' compensation laws of California, and agre
that, if I should becomes je to the worke mpensation pro 'ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio
Signature of Applicant Dat
DECLARATION REG DI G CON RUCTION LENDINGAGENCY
I hereby affirm underlpenalty 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).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
1 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 co ty ordinances and state laws relating to building construction.
I authorize representatives of this city or coun t niter the o-identifie operty for inspection purposes.
Signature of Property Owner or Authorized A en Print Property Owner's or Authorized Agent's Name IC/ ANN A044MW ate 3 /{O
ACftON DATE BY DECLARATION OF COMPLQNCEWIFN COD€OF FOR OFFICE USE ONLY
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PERMtTEXFENDED ❑ AOMD
ASBESTOS NO'RFfCQTtONlS NOT APPLICABLE TO
PERMITFCNAC PROPOSED DEMOUTfON,
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DCCUPANCYISSUED SIGNATURE.