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HomeMy WebLinkAboutE2021-0286 - PermitsCity of Newport Beach - Building Division 11�111�11111111111111p11111111111111111p111111Jil 11Electrical Permit: E2021-0286 w^,� : 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 0387-2021 -`�^ Permit Counter Phone(949)644-3288 �� a :' Inspection Requests Phone (949)644-3255 i�aa�a� Job Address: 1407 SANTIAGO DR Bldg: 1 Floor: Suite: Description of Work: ELEC-TO BBQ Inspector Area: 3 Legal Description: N TR 3851 LOT 53 Owner: WHEELER SHARI Contractor: Address: 1407 SANTIAGO DR Address: NEWPORT BEACH, CA 92660 °®o 00o Phone: Phone: I Con State Lir: Issued Date:04/28/2021 Lic Expire: Processed By: I Bus Lic: 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 or1G0oA: 0 O/H to U/G 0 TOTAL Fee: RICK DORN CONST P O BOX 10047 WESTMINSTER CA 92685 714-585-7322 357535 05/31/2021 BT30074323 02128/2022 Code Edit: 2019 Worker's Compensation Insurance Carrier: WC EXEMPT Policy No: (NO EMPLOYEES) Expire : Plan Check Fee : $0.00 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 ©GO JGm ' _ „cam u� O O O J o o° ( T( m E ° 000 ( 0 0 0 O FEES °®o 00o a o � eo I Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) �S tl»�U Receptacles/Outlets: 2 $3.50 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $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 Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $37.00 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 Plan Check Fee : $0.00 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 ©GO JGm ' _ „cam u� O O O J o o° ( T( m E ° 000 ( 0 0 0 O 6 O °®o 00o a o � eo o oes ou( cea )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 iterit(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 'rofessions 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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). 1 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). 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 residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION 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 Professions Co y license is in full force nd effect. icense Class License No Date Contractor Signature ef VORKERS' COMPENSATION DECLARATION 'ARNING: 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 ($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: ] 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, erformance of the work for which this permit is issued. Policy No. have 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' rance carrier and policy number are: Policy Number Expiration Date Agent JI c rtify 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 agre iat I should become subject to the workers' compensatio Is' s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �/ signature of Applicant , Date / 11-28-zi IECLARATION REGAR NG CONST DING AGENCY hereby affirm under pe alty of perjury at th re is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address ly 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 c agree to comply with all applicable city and county ordinance nd st aws relating to building construction. authorize representatives of this city or county to ant v entified property for inspection purposes. ;ionature of Prooertv Owner or Authorized ADent / Print Prooertv Owners or Authorized Agent's Name% -P -e Date4Z2S^q— AC77ON DATE BY DECLAHA IIUN Ur- L UMPLfANLt YVI r n LUUt Ut FOR OFFICE USE ONLY FEDERAL R&GULAJ1ONS PART 61 OF TITLE40 AND PERMIT EXPIRED AQMD RU4E VQ. • • ` • • e • e ❑ I SUB)I �TE1QSTSTOf JYOTiFICA}!QN Tg: PERMIT CANCELLED ❑ EQ� . • • • ' PERMITEXTENDED ❑ AQMD • �•• �' ❑ ASBESTOS NORFICATION IS NOT APPLICABLE TO PERMITFINAL -'Z• PROPOSED.DEWLITJON, - CER77FICATEOF • • • •°• • ••+ +• OCCUPANCYISSUED SIGNATURE: - • • • •' a e`