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Home My WebLink AboutE2019-0709 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII Electrical Permit: E2019-0709 cn' 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 7 0. 9 n Project No :1674-2019 Permit Counter Phone (949)644-3288 +a Inspection Requests Phone (949)644-3255 Job Address: 428 FERNLEAF AVE : Bldg: 1 Floor: Suite: Description of Work: ELEC-TEMP POWER POLE Inspector Area: 5 Code Edit: 2016 Legal Description: CORONA DEL MAR BLK 433 LOT 10 Owner: 428 FERNLEAF LLC Contractor: JFB PROPERTIES Workers Compensation Insurance Address: 428 FERNLEAF AVE Address: 23986 ALISO CREEK RD STE 112 Carrier: EXEMPT CORONA DEL MAR CA- 92625 LAGUNA NIGUEL CA 92677 Policy No: no employees Phone: 888-463-2111 Phone: 888-463-2111 Expire; Con State Lie: 1045525 Issued Date:10/22/2019 Lie Expire: 10/31/2020 Lie:Processed By: Bus— Exp Date 110/31/20 $9 0 R z CTO I%_0 New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service $0.00', 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or 1000A 0 $0.00 O/HtoU/G 0 $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.lrt ®® oom o000 00` 0 0. 0 e m Em o m mem o 0 o m e 00 omo m a o o�m a c. o 0 •o o®o. o o oo 00 000 0 $0.001 0 $0.00! w'P1 f�/VAIC9Y�tl NP"®"rtl�Rtl 6i.Nt-1 $0.00', $0.001 FEES $0.001 $0.00,, Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: Fixtures: 0. $0.00 1 to 10 HP/KW//KV 0 � �Syp Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 PM � n Vit OtND THE Low Voltage 0 $0.00 50 to 100 HP/KW/KVA 0 $0.00 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: Branch Circuit: 0 $0.00 Plan Check Fee: Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: Time Clocks: 0 $0.00 Temp Power Pole: 1 $39.00 Issuance Feer Additional Fee : $0.00 Supplemental Fee: Plan Check fee : $0.00 Fee Due at Permit Issuanc 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.lrt ®® oom o000 00` 0 0. 0 e m Em o m mem o 0 o m e 00 omo m a o o�m a c. o 0 •o o®o. o o oo 00 000 0 $0.001 0 $0.00! 0 $0.00'; 0 $0.00', $0.001 $0.001 $0.00,, $35.00 $0.00' )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 penalty 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, lusiness 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 Troved 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 note! _ _. only 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: ly my signature below 1 acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of theimprovementscovered 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.html. signature of Property Owner or Authorized Agent D to .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:fe ons o and my license is in full force nd effect. icense Class License No Date22 Contractor Signatur VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE O 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: I 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. 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' carrier and policy number are: Policy Number Date I of Agent Phone# G at, in the p"CONS rk r hic is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree I should becomrs' p sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. qq ature of Applicant Date ILARATION REGATI LENDING AGENCY 4r% i� Eby 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). far's Name Lender's Address iy signature below, I certify to each of the following: I am the property owner or authorized to act on the property own is behalf. I have read this application and the information I have or Ide Is correc . I agree to comply with all applicable city and cou y ordi ce nd at a laws relating tobuildingconstruction. I authorize representatives of this city or count ante a ve-id tified property f ' action purposes. �q/ lall 2 C.y ature of Prooertv Owner or Authorized ADent F % Print Prooertv Owner's or Authorized ADent's Name ;i 1 1 a4ll // l �,{/A�"JIhL bate ACTION DAT • BY EXPIRED • 1�e •e ' CANCELLED • • • • e EXTENDED FINAL ;ATEOF • • • • • • • • • e • e• INCYt55UED FEDERAL REGULATIONS PART 61 OFTITLE40.AND AQMDRULE1403. - I SUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ASBESTOS NOURCATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: