HomeMy WebLinkAboutE2019-0524 - PermitsPERMITS 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.
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FEES
New Construction
III Electrical Permit: E2019-0524'
Center Drive,
s
Motors/Transformers (HP/KVA)
Project No: 1733-2019
- i
Permit Counter Phone (949)644-3288
Receptacles/Outlets:
2
$2.00
0 to 1 HP/KW/KVA:
�^�armrw�*�`'
$0.00
Inspection Requests Phone (949)644-3255
0
$0.00
Multi -Family:
Job Address: 1615 HIGHLAND DR Bldg: 1 Floor: Suite:
$0.00
Fixtures:
Description of Work: ELEC TO BBQ
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
INSPECT®
Inspector Area: 3
$0.00
Code Edit: 2016 -
0
$0.00
..e.
Legal Description: N TR 3800 LOT 11
$0.00
......
Owner: CRARY Contractor:
LANDCRAFTERS INC
• o m' moeecnc.
Worker's Compensation Insurance °•
Address: 1615 HIGHLAND Address:
29512 ANA MARIA LANE
Carrier: EMPLOYEE SERVICE GROUP ° . • e °m
NEWPORT BEACH CA 92660
LAGUNA NIGUEL CA 92677
Policy No: WC58970310 ....
Phone: Phone:
949-249-1086
Expire : 12/01/2019
Con State Lic:
754071
Issued Datei08/01/2019 Lic Expire:
09/30/2020
ee.•om eoeoo
• .
Bus Lic:
BT30039467
Signs
Processed By: -�� Lic Exp Date:
05/31/2020
e • o ° °
0
$0.00
Record Mgmt Fee:
$0.00
0-600V up to 20OA:
0
$0.00
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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:
2
$2.00
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
0
$0.00
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:
$35.00
O/H to U/G
0
$0.00
Additional Fee:
$0.00
Supplemental Fee:
$0.00
TOTAL Fee:
$37.00
Plan Check Fee : $0.00
Fee Due at Permit Issuance :
$37.00
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.
✓ •• 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 apIricable 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 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 or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
'mproved for the purpose of sale).
❑ 1, 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 signatur2be1d% 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 structure tbatl.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
Prpfg§sjions Corte, "available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Pfop@¢y Owner or Authorized Agent Date
WCENSED CONTRACTOR'S DECLARATION
I hereby affirm un d er penalty of perjury that I am licensed under provisions of Chapter 9 (commencing PFEES.
0 0) of Division 3 of the Business a ro sio s e, and my ' nse is in full torte
and effect. , .
.... Date Contractor Signature
LicenseClass License No
(I( WERS' COM IINSATION DECLARATION
NA@y�,r• FAILURE TO SECRIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYPENALTIES AND CIVIL FINES UP TO ON HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
68$Y0 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY
:114911:affirm under penalty of perjury one of the following declarations:
..,.,.
k
ye and will mafitain 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
ance of the•wort for which this permit is issued. PolicyNo.
ve and wilt 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
ee carrier and policy number are:
Policy Number Expiration Date
Name of Agen Phone #
❑I
car that in thej
a C t ork for which this rmit is issued, I shall not employ any person in any manner so as to become subject to the orker5lcoensation laws of California, and agre
that, if I shout becomje th or ns provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision
Signature of ApplicanData
DECLARATION REGNG CONSTRUCTION LENDING AGENCY
I hereby affirm under ty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued ( action 3097, Civil Code).
Lender's Name Lender's Address
By 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 he vided is c I
I agree to comply with all applicable city and cou or d' ate I elating to building construction.
1 authorize representatives of this city or count the a -i ed o inspection purposes..
Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Name i Dat
ACTION I DATE
PERMIT€XTENDED
PERMITFINAL
CERTiFfCATE OF
OCCUPANCYISSUED
❑ ISUBMITTEDASBESTOSNO]IFICATIONTOr
❑ EPA
AQMD
❑ ASBESTOS NO17FICA77ONIS NOT APPLICABLE TO
PROPOSEDDEMOfITION.
SIGNATURE.,