HomeMy WebLinkAboutE2018-0072 - PermitsCity of Newport Beach - Building Division
r5' 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 1014 POLARIS DR BIi
Description of Work: ELEC FOR DOCK
Inspector Area: 3
Legal Description: N TR 4224 LOT 180
Owner: MURPHY ROBERT H
Contractor:
Address: 1215 BAYSIDE DR #103
Address:
CORONA DEL MAR, CA 92625
Phone:
Phone:
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Con State Lic:
Issued Date:02/01/2018
Lic Expire:
New Construction
Bus Lic:
Processed By: b !1�
Lic Exp Date:
SWIFT SLIP DOCK/PIER BUILDERS
6351 INDUSTRY WAY
WESTMINSTER CA 92683
949-631-3121
797052
07/31/2019
BT01122734
11/30/2018
Electrical Permit: E2018-0072
Project No : 1525-2017
Inspection Requests Phone (949)644-3255
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,
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Code Edit: 2016 "2
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New Construction
Receptacle/Switch/Outlets
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Worker's Compensation Insurance'
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Carrier: AMERICAN LONGSHOR
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0
$0.00
Temp Underground:
Policy No:ALMA01662-01
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Expire: 12/31/2018`
$0.00
Fixtures:
2
$2.00
1 to 10 HP/KW/KVA:
0
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0
$0.00
1-2 Family:
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Sep Circuits:
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10 to 50 HP/KW/KVA:
00 0
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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,
FEES
New Construction
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
2
$2.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
2
$2.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
0
$0.00
Low Voltage
2
$2.00
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:
0
$0.00
Issuance Fee:
$33.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL Fee:
$39.00
Plan Check Fee: $0.00
Fee Due at Permit Issuance:
$39.00
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,
OWNER -BUILDER DECLARATION _ r
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 t€m(s)r"
(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
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 penally 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 (_) all of or (_) 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 f proving that it was not built or
improved for the purpose of sale).
❑ I, as owner gi tAd �;pperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contra ors' State License Law does not
ply to pn ownePOfptoperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License w).
• I tnexempt,fl'orp 1i�ensure under the Contractors' State License Law for the following reason:
By my signature betow ►acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of th 'mpfdvem n covered by this permit, I cannot legall)
A 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 t applicable la action 7044 of the Business and
ProfeSSlons Code. jS.auailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.html.
SigrsatlBg of Propgr,(y 91vner or Authorized Agent Data
i10ENSED CONTRA+CTOR'S DECLARATION
hereby affirm uadal•pe� alty of perjury that I am licensed under provisions of Chapter 9 (commencing wit ection 7000) of Division 3 of the Busi ass a7�rofe ions Co , and license is in full force
3PG ElfB�t.
-1cgpje, glass • License No Date I I Contractor Signatur
11ORKERS' CCUDEMSATION DECLARATION
">86AUW ' AILURE TO sECIRtE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER 70 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HOUSAND 0 LRS ($100,000), IN ADDITION TO THE
ddbba70F �A710I$, OAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby ff no rfenalty of perjury one of the following declarations: /
if I
Idm In a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided fol-by'Section 3700 of the Labor Code, for
of t for which this permit is issued. Policy No.
and willIm�intain 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'
carrier an Dolicv.NumberareA
Of
performance
weby affirm under Penalty of pedrjury that therr
Ider's Name II /
my signature below, I certify to ach of t to
I am the property owner or out ri o act
I have read this application and the informal
I agree to comply with all applicable city and
I
I authorize representatives of this city or co
nature of Prooertv Owner or Authorized AGe
AC17ON I DATE
Policy Number Expiration Date
which this permit is issued, I shall not employ any person in any manner so as to become subject to he workers' compensation laws of California, and agre
npen Ion pro Islons of Section 3700 of the Labor Code, I shall forthwith comply with those prove ns 77y�
e.
-ENDING AGEN11 Y
s a construction ending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
// Lender's Address
I have
BY
behalf.
I PERMLTEXP/RED I II / I
I PERMITCANCELLED I I \ / I
relating to building construction.
operty for inspection purposes.
/ Print Prooertv Owner's or Authorized AGent's Name
FEDERAL_ REGULATIONS PART 61 OFTTILE40.AND
AQMDRULE 1403.
I SUBMITTEDASBESTOS N077FICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS N077RCA770NIS NOT APPLICABLE TO
PROPOSEDDEMOLITION.
OCCUPANCYISSUED I I I I SIGNATURE: