The URL can be used to link to this page

Home My WebLink AboutE2019-0776 - Permits04 City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 204 COLLINS AVE Bldg: 1 Floor: Suite: Description of Work: ELEC/BBQ & FIRE -PIT Inspector Area: Legal Description: BALBOA ISLAND SEC 2 BLK 11 LOT 16 Owner: TRIMAR PROPERTIES Contractor: Address: 2015 SHIPWAY LN Address: NEWPORT BEACH CA 92660 $0.00 Phone: Phone: Issued Date:11/20/2019 Con State Lic: Lic Expire: Processed By: Bus Lic: Lic Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 IIIIIIE IIIA ILII 0�I�I IIT IIII TVI 0�III I��II I��I� IIII IIII FERNANDEZ ROBERT CONSTR INC 923 EVERGREEN PLACE COSTA MESA CA 92627 949-981-9169 677390 04/30/2020 BT30046730 03131/2020 Electrical Permit: E2019-0776 Project No: 0763-2017 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: W/C EXEMPT Policy No: (NO EMPLOYEES) Expire : Motors/Transformers (HP/KVA) Receptacle/Switch/Outlets 0 Receptacles/Outlets: 2 $2.00 $0.00 Fixtures: 0 $0.00 $0.00 Sep Circuits: 0 $0.00 0 Low Voltage 0 $0.00 Signs $0.00 Branch Circuit: 0 $0.00 $0.00 Each Add Circuit: 0 $0.00 $0.00 Time Clocks: 0 $0.00 $0.00 Additional Fee : $0.00 37.00 Plan Electrical Permit: E2019-0776 Project No: 0763-2017 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: W/C EXEMPT Policy No: (NO EMPLOYEES) Expire : Motors/Transformers (HP/KVA) 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 Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Due at PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturda yfrgrV 8:00 a.m. to 6:00 p.m. o a • c V Y Y • G ) (. C. •G Otl • • B 4 - i. € p • F FF 4G 1Y• • • G COU :30 9 L 01 6 YL 13G 4'i• 4f L • 6Et) pOU �2 0 i DO .00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 )WNER-BUILDER DECLARATION a Contractors' below by the checkmak() I ced nxt to the I hereby affirm under penalty perjury Code: Any city or county that equires a pterm f Ito construct, oalterr,, improve, demlol sh, or repair any structure -prior t wits ssua ceeapplicable Sate cense Lawalso requires etheapplicant for 'Section 7031.5, Business and Professions :he 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 an 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). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do ro all of rt w portions of the work, and the structure is not intended improves offered for sale (Section 7 044, Business and are not me Cede: The offered for sale. State Licens, thew do ng oes itimpro ement is soldapply to an owner fwithiin o e y ar of complet oho, through ln, the Owner Bui deoyees' or personal rfwill havle the bu den of pro ingthat itpwas ldnot built tor improved 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 no for the projects with a licensed Contractor pursuant to the Contractors' State License Law). apply to an owner of property who builds or improves thereon, and who contracts ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:ion o sBy my ell a structure Ily etbelow I hat I have built as aneowne -builder f i has not been sonal constructed ndence in l its entih I rety by licensed t have esided eontracto s. I understar at least one year lnd that a copy of theapplicable aw,tSection 7044 tof the Businesshis permfit nandnot lega Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) ofDivision 3 of the Business an�Profns Cop, and my license is in full force and effect. Date ( Contractor SignaturkAAA License Class License No WORKERS' COMPENSATION DECLARATION , AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 th p ormance of the work for which this permit is issued. Policy No. I have and alntain 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 carr r ann policy numbe{are' Expiration Date i 1 r t �' I Pvficv Number -I--- . ne of Agen certify that, in the performance of the work for w this 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 if I should become su_ bjyct to the workers' co an atio ovisio of Section 3700 of the Labor Code, I shall forthwith comply with those Dprroovis� ions . ^ � ^ � T nature of Applicant X CLARATION REGA ING CONSTRILICTIOITILENDING AGENCY Ireby 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). Lender's Address ider's Name my signature below, I certifyto each of the fallowing: 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 ora' a ces d state laws relating to building construction. I authorize representatives of this city or county tolent b e -id 'fled >roperty for in�specPioo purposes. ner's or Authorized Agent's Name '� `�1"k� iatue of Property Owner or AUtnorize0 v� DECLARA€JON OF COMPLIANCE WITH CODE OF FOR ACTION DATE +• ••• • pJ�E�pEL��l,.�r� REQIIppNAN 7M SPAR€61OFTITLE40AND ;AC�M'DWE1403. :[2 I:SU69JTT4QASKSTOS NOIIFICATfON €0: Q EPA ,ERMITEXPIRED • • ' • • 7ERMITCANCELLED ❑ AQMD PERMIT EXTENDED ❑ ASBESTOS NOTIFICA170NIS NOT APPLICABLE TO `•+ ••PRQPQSFbPE74; VT/0N. RERMtTFINAL I .•e • E f :SI$NA'PURE?• i CERRFfCATEOF •� QCCUPANCYISSDED •• ••• • • •• •• •.•