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HomeMy WebLinkAboutE2020-0227 - PermitsCity of Newport Beach - Building Division °} 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 es{JAtNI�? Job Address: 4916 SEASHORE DR Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE (X2019-3472) Inspector Area: Legal Description: N TR 3813 LOT 80 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �� Project No Electrical Permit: 2399 E2020-0227 Owner: ALEJO PS89 LLC Contractor: OWNER/BLDR Address: 73-145 FIDDLENECK LN Address: AUTH AGNT: HERRERA RUDY PALM DESERT CA 92663 Phone: Phone: c Con State Lic: O/B Issued Date:07/0 /2 Lic Expire: Motors/Transformers(HP/KVA) Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 TOTAL Fee: Inspection Requests Phone (949)644-3255 Code Edit: 2019 11 NIS 1 EV 1® on Worker's Compensation Insurance Carrier Policy No: Expire : °mma ° oomn oono°° c o Receptacle/Switch/Outlets Motors/Transformers(HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 c°°°eo °mono m ° ° 000°n Plan Check Fee: 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. FEES Receptacle/Switch/Outlets Motors/Transformers(HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: °mG $0!00" $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Backlfemp Power: 0 $0.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $39.00 Issuance Fee: $35.00 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 Plan Check Fee: 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 resson(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 ie 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 k onsCode) 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 than five hundred dollars ($500). 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, 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 nprovements 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 n roved 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 pply 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 I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal re dence in which I must have resided for at least one year prior to completion of the improvements c eyed by this permit, I cannot legally ell a structure that I have built as an owner -builder it has not onslructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Se Ion 7044 of the Business and 'rofessions Code, is available upon request w this applic I n ubmittad or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. n0 signature of Propertyy Owner or Authorized Age D / L. .ICENSED EiRACTOR'S DECLA I heresy affirm Sn'r%penalty of perjury that I am licensed uVer provisions of Chapter 9 (commenping with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force Rdoffect. �j-`{j(v)5,7Y,'�] icense Class• • License No Contracto gnature VORI(ERS' COMPENSATION DECLARATION 'ARNING: FAILURr'IHSEP.URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE b� T OF•COMPEAWIDM, 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: •••••• h and will m2intain 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 rice of the work for which this permit is issued. Policy No. a j and vis ridlilain 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 Isurance carrier-dhd pblicy number are: arrier • _ Policy Number Expiration Date of Agent "' • Phone # that, in the parlor nce f he work for which this permit is issued, I shall not employ any person in any manner so as to become subject ty� the workers' compensations of California, and agree f I should be oma su t I workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov'Sions� / , nature f plicant I ` D CLARATEGA IN CONSTRUCTION LENDING AGENCY �reby affirm under pe alt of perjury that there is a construction lending agency for the performance of the work for which this permit is issued Section 3097, Civil Code). ider's Name Lender's Address 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 orcivided is correct. I agree to comply with all applicable it and coun infances and state laws relating to building construction. > I authorize representatives of this citycganty t r e above -identified property for inspection purposes. U� Da nature of Property Owner or Authorized ant Print Property Owner's or Authorized Agent Na AC77ON RATE By DECLARATION OF COMPLIANCE MTH CODE OF FOR OFRCE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMDRUL€ 9403. PERMIT€XPIRED © L SUBMITTED ASBESTOS NORRCATION TO: ❑ EPA [3 AQMD PERMITCANCELLED PERMIT€XTENDED D ASBESTOS NOTIRCATION IS NOT APPUCAB.E TO PROPOSED DEMOLITION. PERMITFfNAt 6 Z 1 CE TIFIC TEOF OCCUPANCYISSUED SIGNATURE: