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Home My WebLink AboutE2019-0826 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 H �^ Permit Counter Phone (949)644-3288 w u i3 c. �a Job Address: 182 SHORECLIFF RD Bldg: Description of Work: ELEC/PIGGY BACK Inspector Area: 5 Legal Description: N TR 1116 LOT 100 Owner: HOHMANN DAVID Contractor: Address: 182 SHORECLIFF RD Address: CORONA DEL MAR, CA92660 $0.00 Phone: Phone: $0.00 Con State Lic: Issued Date:12/06/2019 Lic Expire: 0-600V over20OA: Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0 $0.00 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: II IIS I ILII VIII IIT VIII IIII 0IIII IIID ILII III II TONY VALENTINE CONST INC 2435 E COAST HWY #2 CORONA DEL MAR CA 92625 949-723-6449 467553 04/30/2020 BT00021099 02/28/2020 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Worker's Compensation Insurance $0.00 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Electrical Permit: E2019-0826 Project No : 1135-2017 Inspection Requests Phone (949)644-3255 FEES 0 $0.00 �J Code Edit: 2016 $0.00 0 to 1 HP/KW/KVA: 6I $0.00 M Worker's Compensation Insurance $0.00 Carrier: STATE COMP INS FUND �I Policy No: 1794693 50 to 100 HP/KW/KVA: Expire: 07/01/2020 $0.00 Over 100 HP/KW/KVA: X 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: 1 $39.00 Temp Power Pole: 0 $0.00 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: $0.00 Supplemental Fee: $10.00 Fee Due at Permit Issuance : 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, vu• s • ®. • m o, O P f C 4. e0 L O O 0Y p pc PCO &e t0 � � O a o cu c eo® ae an r o aou co IWNER-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) Lection 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). - i 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, ',usiness 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 nproved for the purpose of sale). II 1 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 pply 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: ly my signature below 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 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.htmi. signature of Property Owner or Authorized Agent Date .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 Professions Code, and my license is in full force not effect. icerise Class License No Date__ -j /+ Contractor Signatur VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO 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: ] 1 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 thl gJformance of the work for which this permit is issued. Policy No. 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' rance carrier an pp l number are: Date ame of Agent ) rT t!os1 OY Z;L rnone rF ]I certify that, in the performance of the work for which 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 agre sat, if I should become subjec o the workers' provis>�of Section 3700 of the Labor Code, I shall forthwith comply with those pr via ns. ignature of Applicant l Dat iECLARATION REGARAANGCON RUCTION LENDING AGENCY hereby 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). ender's Name Lender's Address y 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 have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or courttoQyAer theft0eude fled propert for inspection purposes. ''�� [[�� /��{�AI ��O icnature of Prooertv Owner or Authorized Agent �/; Print Property Owner's or Authorized Agent's Na`, /Z sc6stl a„ /1'l03io iP.fJ Da Z - ACTION DATE BY V ULAJ IJVJV yr uviwruAiv -C vn,r i.vvr_vJ FEDERAL REGULATIONS PART 61 OFTITLE40AND 49I,1LE1447• • ••• ••• PERMITEXPIRED 1 SIJBMfTrfU;A.JBPSTOS I077Fl4:ATION TO: • • ❑• EPA •• • 11. AQMV1• ••• ••• �• PERMITCANCELfED PERMIT EXTENDED ❑ ASBESTOS NORRCARONfS NOT APPLICABLE TO PROPOSED DEMOLITION. • + • • • • ...• ° + PERMIT FINAL CERTIFICATE OF OCCUI.PANCY75SOED SMIN4TUR�.