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HomeMy WebLinkAboutE2020-0186 - Permitswlv�4 City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1700 SKYLARK LN Bldg: 1 Floor: Suite: Description of Work: ELEC-DISCONNECT FOR A/C Inspector Area: 3 0 Legal Description: N TR 3082 LOT 63 Receptacles/Outlets: Owner: MATSLER SEAN/NATALIE Contractor: Address: 1700 SKYLARK LN Address: NEWPORT BEACH, CA 92660 Fixtures: Phone: Phone: 1-2 Family: Con State Lic: Issued Date:04/07/2020 Lic Expire: 0 Bus Lic: Processed By: to Lic Exp Date: Electrical Permit: E2020-0186 IIIII�IEIII�II�II0III�IIIIIIIII�II�IIIIIIIIIIIIIIIIIIIIIIII Project No : 0038-2020 GRAVES M H INC 5852 MULLER ST BELL GARDENS CA 90201 562-833-3703 241731 03/31/2022 BT30034436 04/30/2021 New Construction Receptacle/Switch/Outlets Residential 0 $0.00 Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 Service 0 $0.00 Low Voltage 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Signs $0.00 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: ¢aq on $0.00 TOTAL Fee: $62.00 Plan Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: OAK RIVER INSURANCE Policy No: MHWC127932 Expire : 01/01/2021 EG Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 1 $27.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 Piggy Backrremp Power: 0 $0.00 Plan Check Fee: Investigation Fee: $0.00 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 Fee : $0.00 Fee Due at Permit Issuance - ¢aq on PERMITS EXPIRE 980 DA YS 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. l GGC F B C f C CVO U 4] a �o� ccc o a e obc o c o ¢ce © o v c v c a� oar v e vv ca c®c NNER-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) action 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 far e permit 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) o rmit tta f Division 3 of the Business and a e rmit t Code) or that to 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 It more than five hundred dollars ($500). ( )all of or L) portions of the work, and the structure is not intended or offered for sale (Section,pprovidedthat44, ] 1, as owner of the property, or my employees with wages as their sole compensation, will do employees' or personal effort hat the the Owner -Builder will usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through , builds have the burden of proving that it was not built or improves the property, p 1provements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, iproved for the purpose of sale). ] I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section Contractor Business and Professions Code: The Contractors' State License Law does no )ply 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). I am exempt from licensure under the Contractors' State License Law for the following reason: y 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 -11 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 I , Secti n 7044 of the Business and rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. a ignature of Property Owner or Authorized Agent ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencinXwith ecti n 70 ) of Division 3 of the Business and Pr ion ode, and my license is in u orce nd effect. Da � Contractor Signa!cense Class License No VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST 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: a 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 th e rmance of the work for which this permit is issued. Policy No. k for which this permit is issued. My workers' compensatio and will maintain workers' cor carrier and policy number are: is of Agent certify that, in the performance , if I should become sulv*t to insurance, as required by Section 3700 of the Labor Code, for the performance of the wor o Date Policy Number permit is Issued, I shall not employ any person in any manner so as to become subject to the i Drovisions of Section 3700 of the Labor Code, I shall forthwith comply with those proyisi tea.. nature of Applicant — V CLARATION REGARD N CONSTR I LENDING AGENCY ereby affirm under pen y of perjury that there is a construction lending agency for Lender'r's Address of the work for which this permit is issued 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 with6ll applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. c 1 D�I,a Dr„oenv Owner's or Authorized Agent's Nan Aj,"TION DATE I - BY • • o • • • e e FEDERAL REGULATIONS PART 67 OF TITLE40AND AQMD RULE 1403. ❑ I SUBMITTEDASBESTOS N071FICATION TO: EPA ❑ AQMD ❑ ASBESTOS NORRCATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. CERURCATE 01 •' • • : s : • es SIGNATURE: laws of California, and Code). Date