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Home My WebLink AboutE2017-0495 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 F " Permit Counter Phone (949)644-3288 N Job Address: 3621 SAUSALITO DR Bldg: 1 Floor: Description of Work: ELEC TO BBQ Inspector Area: 4 Legal Description: N TR 6229 LOT 6 Owner: EDWARDS GARY AND NAOMI Contractor: Address: 3415 SEABREEZE LN Address: CORONA DEL MAR, CA 92625 Phone: Phone: Con State Lic: Issued Date:09/25/2017 Lic Expire: Bus Lic: Processed By: Lic Exp Date: II�IEIII2 0�IIIILIIIII III III4I�II5II II G D M LANDSCAPE 31878 DEL OBISPO, STE 118 #435 SAN JUAN CAP CA 92675 949-433-0057 881282 09/30/2019 BT30048427 09/30/2018 New Construction 0 $0.00 Receptacle/Switch/Outlets Residential $0.00 0 to 1 HP/KW/KVA: Receptacles/Outlets: 1 $1.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 $33.00 Policy No: WWC3258893 Low Voltage 0 $0.00 Service mm a Signs memoo 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or I OOOA: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: Electrical Permit: E2017-0495 Project No: 1471-2014 Inspection Requests Phone (949)644-3255 Code Edit: 2016 0 $0.00 Motors/Transformers (HP/KVA) w4• $0.00 0 to 1 HP/KW/KVA: i a9 $0.00 1 to 10 HP/KW/KVA: ,:.;rhe•'.. $0.00 10 to 50 HP/KW/KVA: �, a 50 to 100 HP/KW/KVA: 0 $0.00 Worker's Compensation Insurance <.. $0.00 Carrier: WESCO INS $33.00 Policy No: WWC3258893 e o m 7'e o Expire: 03/21/2018 0 omo mm a m ® •e m memoo ommoo 0 o oemon 0 0 0 0 moommm m m o emm m mmmmom o 0 o c em •mmo FEES 0 $0.00 Motors/Transformers (HP/KVA) 0 $0.00 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 Fee : Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $33.00 Supplemental Fee: $0.00 Fee Due at Permit 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(sl (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 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 improvements are not intended or offered for sale. If, however, the building orimpfdLement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ` a 0 ❑ 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 bpor )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) s01W ivicture 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�isevailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signattwe of PropdrtyOwner or Authorized Agent Date LICEASED CONTRACTOR'S DECLARATION I hereby affirm under pEt alty of perjury that I am licensed under provisions of Chapter 9 (commencing with cti n 70 0) of Division 3 of the Business and P 6fessi n ode, and my license is in full force andeffeot. •• rI� L1cense Class License No Date !r✓ �7 Contractor Signature VYQliK6RS' cbrAPENSATION DECLARATION NARNING: FAILURE TO.SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOO E HUNDRED THOUS D DOLLARS (6100,000(, IN ADDITION TO THE CpS:dP1OMPENSA.TION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. frereby-affirm ufltler•131 alty of perjury one of the following declarations: 12 I Mavis 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 tht pe Hance of CV%vork for which this permit is issued. Policy No. I 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' compensation insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # 131 certify that, in the pert Trance of the rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to th or am' compensation laws of California, and agref that, if I should become bject to the rs compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi . ^ ��' Signature of Applicant Dat NI DECLARATION RE RDING CON UC ION LENDING AGENCY I hereby affirm unde penalty of perjury d ( re is a construction lending agency for the performance of the work for which this permit is issu Section 3097, Civil Cade). Lender's Name Lender's Address By my signature billow, 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 cou ordinan s and state laws relating to building construction. I authorize representatives of this city or countY��ro�kv�{t� th ab ve-identified property for inspection purposes. �+ , ,f r/ '// j7 .,,.....,...e ,.e o.,.__ed n,.,�e..,. A, an...�,e.I A�onr / 7 \ � Print Prooertv Owner's or Authorized Agent's Na l`�E C !ZLt_y F Da ACTION DATE BY oas.,...v.... .... ... ..u,... FEDERAL REGULATIONS PART& OFTITLE40AND P€RMITEXPIRED AQMO RULE 1403. ❑ I SUBMLTTEDASBESTOS NOTIFICATION T0: PERMIT CANCELLED ❑ EPA P£RMIT£XT€ND£D ❑ AQMD ❑ ASBESTOS NOTiRCARONIS NOT APPLICABLE TO PERMITFINAL p PROPOSED DEMOLITION. C£RRFICAT€OF SIGNATURE. OCCUPANCYISSUED