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Home My WebLink AboutE2017-0512 - Permits.t City of Newport Beach -Building Division �IIIIIIIIIIIIilllllllllllllllll�lllllllllllllllllll JillElectrical Permit: E2017-0512 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 7 0 5 1 2 Project No: 1135-2017 w Permit Counter Phone (949)644-3288 0) c,��#st,uN�'x Inspection Requests Phone (949)644-3255 Job Address: 182 SHORECLIFFRD Bldg: IFloor: Suite: Description of Work: ELEC/TEMP POWER POLE 'i a 7 Inspector Area: 5 Code Edit: 2016 Legal Description: N TR 1116 LOT 100 Owner: HO HM AID Contractor: TONY VALENTINE CONST INC Worker's Compensation Insurance Address: 18 ORECLI F RD Address: 2435 E COAST HWY #2 Carrier: STATE COMP INS FUND RONA DEL AIR CA12610 CORONA DEL MAR CA 92625 Policy No: 1794693 Phone: Phone: 949-723-6449 Expire: 07/01/2018 Con State Lic: 467553 Issued Dat :10/04/2017 Lic Expire: 04/30/2018 Bus Lic: ST00021099 om Processed By: Lic Exp Date: 02/2812018 ooca `crm 000a a c 0o c °ocoa a FEES ° mraoo New Constructiol Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) ° Residential Receptacles/Outlets: 0 $0.00 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 = EO $0.00.` 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 010 $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: 1 $36.00 Issuance Fee: $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $10.00 TOTAL Fee: $46.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $46.00 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. )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 (_) all of or (_) 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 nproved for the purpose of sale). 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.html. - ;ignature 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 nd effect. ""': ` ^ � /� iGerSei;lass License No Date Contractor Signature XJ VORKERS' CbMPENSATION DECLARATION jAWING:.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 O)FCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penally of perjury. one of the following declarations: h11114 a and Wi(I,rpaintain 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 R10MVce of the�mjl for which this permit is issued. Policy No. v 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' compensatior Pfi carrier Rnd policy number are: ' ".": Policy Number Expiration Date certify that, ih the performance , if I should become subject to I of 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 agree kers' c pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date /4e-11r7r% IECLARATION REGARDING CONSTRUCTION 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 ly 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 county to enter the o -ide 'ed property for inspection purposes. Print Property Owner's or Authorized Agent's Na �'�2 / " "'"�" Signaturepf Property Owner or Authorized Agent �l� �� P _ y _ g ny�� / � Dgte�� ACTION DATE BY DECLARATION OFCOMPLIANCE tMTNCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART fir OFTIMEW AND AQMORULE1403. PERMITEXPIRED ❑ t SUBWTTEDASBESTOS N071FICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOIIRAC47ION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITFINA.L CERTIFICATEOF OCCUPANCYISSUED SIGNATURE.