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Home My WebLink AboutE2019-0634 - PermitsCity of Newport Beach - Building Division + .100 Civic Center Drive, Newport Beach, CA 92660 ti Permit Counter Phone (949)644-3288 Job Address: 1211 CLIFF DR Bldg: 1 Floor: Suite: Description of Work: ELEC/TEMP. POWER POLE Inspector Area: 2 Legal Description: N TR 1219 BLK B LOT 1 Owner: HILL II RUSH N Contractor: Address: 115 22ND ST Address: NEWPORT BEACH, CA 92663 $0.00 Phone: Phone: $0.00 Con State Lic: Issued Date:09/18/2019 Lic Expire: 5 0 Bus Lic: _ Processed By:_ 57 0 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 or 1000A: 0 $0.00 0/H to U/G 0 $0.00 TOTAL Fee: $74.00 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Project is l Permit: r itg E2019-0634 p PDC INC 1010 S HATHAWAY ST UNIT C SANTA ANA, CA 92705 (714)664-0477 988559 11/30/2019 BT30055261 06/30/2020 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs 50 to 100 HP/KW/KVA: 0 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Plan Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: EVEREST PREMIER INS CO Policy No: 7600020452191 Expire : 05/29/2020 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 $39.00 Fee : Temp Underground: Sub Panel Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: at Permit PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Sat® rdayorom,8.00 a.m. to 6:00 p.m. e a e m o c - L O A V J O O O O L. 4 VC L 4 CU �Y 4 6 L f 6CV 9 9 C 6UQ vE 4 G U 4 G - C D 9 S iGY Oi 4G A U iiUU GGV $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 )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). I, as owner of the property, or my employees with wages as their sole compensation, will doall of `) portions of the work, and the structure is not intended offered for sale (Section 7044, 3usiness and Professions Code: The Contractors' State License Law does not apply to an ownerr o of property y 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 1t was not built or mproved 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 no 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.gov/calaw.html. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION a is in full force I 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 Prof de, d-I*+Ytiaens and effect. License No Date Contractor Signatu License Class / _ w WORKERS' COMPENSATION DECLARATION WARNING: 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 (4700,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5108 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 th pe ormance of the work for which this permit is issued. Policy No. ,,have and viffl"Waintain 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' compensatio policy Number Date ne of Agent 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 agree if I should become subject to w s' compensati provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisiops. Date nature of Applicant CLARATION REGAFMG CONSTRUCTION LENDING AGENCY prformance Ireby affirm under penalty of perjury that there is a construction lending agency fo the ar's Address of the work for which this permit is issued'(Section 3097, Civil Code). Ider's Name 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 ordi nce a state laws relating to building construction. Pte...` I authorize representatives of this city or county to ter entified e y or Inspection purposes. \ D .,ar�„a of Prooertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name X t ACDON I DATE I BY • i • i k.' .. • • wlie 0 -I5&B&•TTELl4BESTOSNOTTFTCATTONTO: Q UAi 11 AQMD ❑ ASBESTOS NOTTFTCATTONTS NOT APPLICABLE TO PERMITFTNAL J -If V - -V" CERTSRCAT€OF •o i •� i OCCOPANCYISSOED