HomeMy WebLinkAboutE2021-0266 - PermitsCity of Newport Beach - Building Division
a+ 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 1224 HIGHLAND DR Bldg: 1 Floor: Suite:
Description of Work: ELEC TO BBQ
Inspector Area: 3
Legal Description: N TR 3031 LOT 74
Owner: CAMPBELL FRANK
Contractor:
Address: 1227 SOMERSET LN
Address:
NEWPORT BEACH, CA 92660
0 to 1 HP/KW/KVA:
Phone:
Phone:
1
Con State Lic:
Issued Date:04/12021
Lic Expire:
$0.00
Bus Lic:
Processed By:
Lic Exp Date:
G D M LANDSCAPE
31878 DEL OBISPO, STE 118 #435
SAN JUAN CAP CA 92675
949-433-0057
881282
09/30/2021
BT30048427
0913012021
New Construction
V. °$0.00
Sub Panel:
Receptacle/Switch/Outlets
Residential
0 to 1 HP/KW/KVA:
0
Receptacles/Outlets:
1
$1.75
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Service
Signs
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Electrical Permit: E2021-0266
Project No : 2331-2019
Inspection Requests Phone (949)644-3255
Code Edit: 2019 QS3T
OR
Worker's Compensation Insurance
Carrier: SECURITY NATIONAL INS CO
Policy No: SWC1328968
Expire : 03/21/2022
FEES
V. °$0.00
Sub Panel:
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 Backrremp Power: 0 $0.00
Temp Power Pole: 0 $0.00
Plan Check Fee:
e�oo
° o
C000 0.11
Temp Underground:
V. °$0.00
Sub Panel:
`0 10$0.00
°6O°°$0.00
d°°°$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
00° °$0.00
Investigation Fee:
Issuance Fee:
... $27.00
Supplemental Fee:
$0.00
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.
)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
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 and
Irofessions 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
lot more than five hundred dollars ($500).
1, 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,
3usiness 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
mprovements 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). _
7 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
Ipply 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).
7 1 am exempt from licensure under the Contractors' State License Law for the following reason:
3y 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
yell 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
Irofessions 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 Secti n 70 O) of Division 3 of the Business and P fe s Code, and my license is in full force
Ind effect.
.icense Class License No �I' Cont for Signature
YORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR USAND DOLLARS ($100,000), IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby afar m under penalty of perjury one of the following declarations:
I have•and•%till 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 the
rmVg%gf the work for which this permit is issued. Policy No.
o .
ve arjwMl 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
urance carrier and policy number are:
Policy Number Expiration Date
Phone #
ertify4ffdt,`g the performance of thork 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
if I shoelj�bypome subject tglhowbrl rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pyvis ions.
TION LENDING AGED
hereby affiAm uAder penally of perju'"at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Nems • Lender's Address
y my signature* Lelow, 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 prov'Sfe correct.
I agree to comply with all applicable city and county o in �as a 1d state laws relating to building construction.
I authorize representatives of this city or county to ant U abov -identified property for inspection purposes.
Signature of Property Owner or Authorized Ag&W Print Property Owner's or Authorized Tit's Name
ACTION DATE Y
DECLARATION OF COMPLIANCE VWTR CODE OF 11
FOR OFBCE USE ONLY
FEDERAL REGULATIONSPART 61 OF ATL€40 AND
AQMO RULE 1403.
PERMITEXPIRED
❑ ISUBMITTEDASBESTOS NOAFICATRON TO.
❑ EPA
❑ AQMO
PERMITCAIVCELLEO
PERMITEXTEIVOED
13 ASBESTOS NOARCAAON IS NOT APPLICABLE TO
PROPOSEDDEMOLITION.
PERMITFINAL
-'LO.
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED