HomeMy WebLinkAboutE2019-0795 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
w' Permit Counter Phone (949)644-3288
A
Description of Work: ELEC PEGGY BACK
dif.A- plrf� ,
Inspector Area:
Legal Description:
8
N TR 1501 LOT 24 7 /,*
Owner: ANDREWS S/
Address: 20451 BAY VI
NEWPORT BE
Phone: 949-351-1324
Issued Date:11/27/2019
Processed
New Construction
Residential
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2019-0795
E 2 0 1 9 0 7 9 5 Project No : 0402-2018
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SONH C on ra tora.: AW� s ELDER
AVE _&ddressr' ANDRE�"4
H' ta0 ��
e: rX r ' ' T8
o to '1 L1
:x
Multi -Family:
01
Of
1-2 Family:
0
$ f
Service
to 0 $0.00
$0.00
0-600V up to 20DA:
0
$0.0
0-600V over 20OA:
0
$0.0
Over 600V or1000A:
0
$0.00
O/H to U/G
0
$0.00
Lic iE Exp Date
Exp
�� G`d`rigb:A
$� Receptacles/Outlets: 0
Fixtures:
dec
� 0
Branch(g+ttiofi� �a�r0�
Each Add Circuit: 0
Time Clocks: 0
Inspection Requests Phone (949)644-3255
E. �kcd,O i', Code Edit: 2016 ago
Worker's Compen_satien I
to
y No:
Expire :
is
FEES a a 8 1
MotoU"r�q,mn
$0.00
0 to 1 0 $6 ppad)
S
k$,,0✓'Q1to
1/KN {ry \W -00
10 50 HP/KW/op
SOdO
to 0 $0.00
$0.00
50 to 100 HP/KW/KVA: 0 $0.0
Over 100 HP/KW/KVA: 0- 0.00
$0.00
S.P• In i
$0.000
'
' gy Backlfemp Powc --1— 39.00
UO
Temp Powe le -"-
$0.00
_
Fee :
Sub Panel:
1"nvestigation Fee:
Issuance Fee:
Supplemental 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.
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$0.00
0
$0.00
0
$0.00
0
$0.00
$0.00
$0.00
$0.00
$35.00
$0.00
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 applice .,em(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% applicant for
is 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
essions 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 suby---ts the applicant to a civil penalty of
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 U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nproved 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).
1 am exempt from licensure under the Contract Fs' State License Law for the following reason:
ly my signature below I acknowledge that, exce 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 legal
ell a structure that I have built as an owner -b ' der if it has not been constru ed in its entirety by licensed contractors. I understand that a copy of the applicable law, action 7044 of the Business and
Irofessions Code, is available upon reqL(e§Vhen this application is supmR RZat the following Web site:http://www.leginfo.ca.gov/calaw. html.
signature of Prpljgrty.Qwner or Authorized ftent Date I t
.ICENSED CONTRACTOR'S DEC ION
AAr@AQ affirm pa4elrp&nalty of perjury that I am licensed under pro Bions of Chapter 9 (commenXD
ith Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
.nd eject.
Icense.Class • License No Contractor Si ature
1(ORt(ERS' COMPENSATION DECLARATION
IARNINO? FAILURE re SEOURE 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 THI
OS?dF COMPE%SAT191k.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LA13OR CODE, INTEREST, AND ATTORNEY'S FEES.
A21E6y affirm ppeter penalty of perjury one of the following declarations:
•
••
I 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 tl
• r%nce of the woik for which this permit is issued. Policy No.
• •••••.
Ye 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' compensatic
Isuran a carrie"nd policy number are:
anner • • •. • • Policy Number Expiration Date
Agent
tify 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
I should become subject to the w9"rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
CLARATION REGARDING CONgXRUCTION LENDING AGENCY
Ireby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
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 provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this cit county to a abp ve-identified property for inspection purposes.
' ed A
nature of Prooertv Owner or AuKo oent lzt-Wf--) _ Print Property. Owner's or Authorized Agen
11—/2'7 / !i
,
action 3097, Civil Code).
ACTION - I DATE BY vct.i.t+rvarrvry yr vveviruwrr.r_rrrrre a.v rvn yr L/
FEDERAL REGULATIONS PART 61OF 117LE AND
PERMIT EXPIRED AQMDRULE 1403.
❑ 1 SUBMITTED ASBESTOS IV077FICATION T0:
PERMITCANCELLED ❑ EPA
PERMITEXTENDED ❑ AQMD
❑ ASBESTOS M077FICAIIONIS NOT APPLICABLE TO
PERMITFINAL PROPOSED DEMOUTION.
CERTIFXATE OF
OCCUPANCYISSUED SIGNATURE:
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