HomeMy WebLinkAboutE2020-0107 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 1672 PEGASUS ST Bldg: 1 Floor: Suite:
Description of Work: ELEC /BBQ
Inspector Area: 8
Legal Description:
Owner: BERNARD KYLE
Contractor:
Address: 1672 PEGASUS ST
Address:
NEWPORT BEACH CA 92660
0
Phone:
Phone:
0
Con State Lic:
Issued Date:02/20/2020
Lic Expire:
1 to 10 HP/KW/KVA:
Bus Lic:
Processed By: NA
Lic Exp Date:
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over20OA: 0
Over 600V or 1000A: 0
O/H to U/G 0
TOTAL Fee:
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II Electrical Permit: E2020-0107
Project No: 2443-2019
SWAN POOLS OF SOUTHERN CA
24512 BRIDGER ROAD
LAKE FOREST CA 92630
949-859-8466
440333
03/31/2020
BT96008994
07/3112020
Receptacle/Switch/Outlet
Inspection. Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9228545
Expire : 04/01/2020
Receptacles/Outlets:
3
$0.00
Fixtures:
0
$0.00
Sep Circuits:
0
0
Low Voltage
0
1 to 10 HP/KW/KVA:
Signs
$0.00
$0.00
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee :
$0.00
Inspection. Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9228545
Expire : 04/01/2020
Plan Check Fee :
Temp Underground:
FEES
$0.00
Sub Panel
s
Motors/Transformers (HP/KVA)
$3.00
0 to 1 HP/KW/KVA:
0
$0.00
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
$35.00
Over 100 HP/KW/KVA:
0
$0.00
$0.00
$0.00
Piggy Back/Temp Power:
0
$0.00
$0.00
Temp Power Pole:
0
$0.00
$0.00
Plan Check Fee :
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:
$35.00
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 frgm 8:00 S.mo �o,6:00.m.
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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 it na(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 applicaA for
the 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
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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business 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
improvements 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
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 not
apply 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:
By 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
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.htmi.
Signature of Property Owner or Authorized Agent Date eq
LICENSED CONTRACTOR'S DECLARATION -
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Division 3 of the Business an r e C e, d license is in full force
and effect.
License Class License No Date Contractor Sign
atu
NORKERS' COMPENSATION DECLARATION
NARNING: 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 ($700,000), IN ADDITION TO THE
COST 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:
❑ 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 thf
IXfbrmance of the work for which this permit is issued. Policy No.
ave 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
nce carrier and policy number are:
of Agent
Number Expiration Date
Phone #
UI certify that, in the p rforma o wo fo hi his permit is issued, I shall not employ any person in any manner so as to become subject. to the worke ' comp nsation laws of California, and agre
that, if I should beco as sub' t wor rs' o nsation provisions of Section
3700 of the Labor Code, I shall forthwith comply with those provsions.
2 Zei
Signature of Applica
D' t
DECLARATION REGA I NSTRUCTION LENDING AGENCY
I hereby affirm under pen Ity of perjury that there is a construction lending agency for the performance of the work for which this permit is issued ( ection 3097, Civil Code).
Lender's Name
Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the roperty owner's behalf.
I have read this application and the information have p vided is correct.
I agree to comply with all applicable city and co my ordin s to s
ting to building construction.
I authorize representatives of this city or county enter ove enf pr
rty for inspection purposes. ff /
Signature of Property Owner or Authorized A ent,
Print Property Owner's or Authorized Agent's Nam
�P'Br Date
ACTION OiqTEX. RY
DECLARATION OF COMPLIANCE WITH CODEOF
FOR OFFfCE USE ONLY
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