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Home My WebLink AboutE2020-0495 - Permitswtao City of Newport Beach - Building Division iJ 100 Civic Center Drive, Newport Beach, CA 92660 _ Permit Counter Phone(949)644-3288 C'a41V41N.Hx� Job Address: 523 SIGNAL RD Bldg: 1 Floor: Suite: Description of Work: ELEC/TEMP POWER POLE Inspector Area: 3 Legal Description: EIII ILII0 ILIIIII �I II II4III�II ISII II Owner: VALEN ANT NY Contractor: TONY VALENTINE CONST INC Address: 523 GNAL RD Address: 2435 E COAST HWY #2 N PORT BEACH A 92663 0 CORONA DEL MAR CA 92625 Phone: 9 9-584-9594 Phone: 949-723-6449 0-600V over20OA: Con State Lic: 467553 Issued Date:09/1 20 Lic Expire: 04/30/2022 O/H to U/G Bus Lic: BT00021099 Processed By: Lic Exp Date: 02/28/2021 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 or 100oA: 0 $0.00 O/H to U/G 0 $0.00 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs 0 e o �0000° $0.00 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: 0000� a $0.00 . Plan Electrical Permit: E2020-0495 Project No: 1172-2020 Inspection Requests Phone (9.19)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: STATE COMP INS FUND Policy No: 1794693 0 $0.00 Expire 07101/2021 0 e o �0000° $0.00 10 to 50 HP/KW/KVA: 0 0 50 to 100 HP/KW/KVA: 0 0o mmo�� Over 100 HP/KW/KVA: 0 0 0 0000� a < o o 0 c000co 0 e 6a . CC O O O O 1C., N FEES 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: 1 $41.00 Fee: o a TempUndergrounr: o °00`0 Sub Panel: 0000 0 o � • oo�o 0 Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: 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. Issuan,e: eo«� $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.00 'NER-BUILDER DECLARATION I herebyaffirm'L nder 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 -ll -:e applicablehem(s) ction 7031.5, BuEiness and Professions Code: Any city or County thatrequires a permit to construcp alter,.. improve,.. demolish,. orrepair .:any structure, prior to its issuance,.also : re quires the :applicant for permit to File si Ined statementthat he or she'is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9:(commencing with Section 7000) of`Divishn3 of the Business: and Fessions Code) o that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7039.5 by any applicant fora permit subjects: the applicant: to a. civil penalty of more than five hundred dollars ($500). as owner of the property,. or my employees with wages as their sole compensation,will do U all ass and Professions Code: The Contractors' State License Law does not apply to :an owner of pr vements are nci intended graffered for sale. If, however, the building or improvement is sold wil (Section 7044, I,, providedthat the tit was not builtor 1, as owner of:thc property, am: exclusively: contracting with licensed Contractors to.construct the project (Section 7044, Business and Professions Code. The Contractors' State License law does: not Ilyto anowner of property who builds ortmproves thereon, and who contracts for theprojects with a licensed Contractor pursuant. to the Contractors' State: License -Law), I. am exempt from licensure under the Contractors' State License Law :for (he following. reason: . my Signature beirw 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 I lis. permit, I.cannot lel a: structure that lI 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,.rSection 7044 >f the Business and fessions Code, is available upon request when this application is submitted or at the following Web: site:http://www.leginfo.ca.gov/calaw.htmi. I, I hereby affirm under penalty of perjury that t.am licensed under provisions of Chapter 9 (commencing Cow Sectiop 7000) of Division 3. of the: Business and Professio s de I i) y 'cense Is in full f Tce andeffecjj�••• r �J7�� License Olais..� 6 License No Date Contractor Signature •••• WORKERS'C(JM!'ENSATIONDECLARATION • WARNING:F4164rr TO ° ECUREWORKERS' COMPENSATIONCOVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS 14100,000), IN ADDITION TO THE ••• COST OF COMPENSATIO'4, DAMAGES AS. PROVIDED DOWN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. • I hereby affirm under penaltyof perjury one. of the following declarations: • •, 11 haJb•aAti-JJI I iaintain 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, • r1h ante of theYork. for which this permitis issued. PolicyNo. E �r1'd vy4R mvintain workers'. compensation insurance, as required by Section 3700 of the Labor Code, forthe performance of The work forwhich-this permit. is issued. I,ly workers' compensatior te carrier anc policy number are: • • •+ Earder • Polhcv Number Expiration Date + • • —s—T— • Name of•Agepl • PhoneC • • • Of cenifytbat•in thl:. ormanaof t orkSor �B.Istlim"r thsrmit is Issued,, shall erson Inany manner so as'tobecome subject lo. the workers' compensation Is vs oFCaliFomia, and:agrel • • • that, if I aheuld beta a uojectto th o r ' c roy=^n ecbon 3700.ofthe LabarCatle, 1 shall forthwilh;comply with those pro Bions. ^•.+•C,j, Signature of Applica I - Date '-� (�'.� DECLARATION RE,ARDING CO , TIONILENDING AGENCY 'v I hereby affirm unde- penalty of perju tthem is a construction lending agencyf r the performance of the:work.for which this permit is issued (Section 3097,: Civil Code). Lenders Name Lender's rAddress By my signature below, I certify to each of the following: I am the propert' owner r authorized to act on the propertyowne ehalf. I have read this ipplication and the informations have pr Is 0 e I agree to comply with all applicable city and conn In c s relabng::to building. construction. ` I authorize representatives ofthis city or cou ty oenter t a is roperty for inspection; purposes: �w-+� 1 V ' q) fir ACfIOId DATE 8Y- VECLANE REGON F FIVANCE M77 CODE OF FOR OFFICE US, -ONLY FEDE UU TIONS PART1 OFTIRE40 AND AMO RULE) 3, I SUBMI EDASBESTOS:NOTIFICATION TO. A QMD PERMffEXPIREC PERMIT CANCELED PERMIT=, , NOM 171 ASB TOS 17MCATIONIS NOTAPPLICABLE TO PROP0 ED OE TI N. PERMITFtNAI i7 " CERTIFICATE OF " SIG TU E: OCCtfPANCYISS JED 2Z: