HomeMy WebLinkAboutE2019-0800 - Permits*t�k, City of Newport Beach - Building Division
b�' 9 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 2532 CRESTVIEW DR Bldg: 1 Floor: Suite:
Description of Work: ELEC - PIGGY BACK METER (X2019-3834)
Inspector Area: 2
Legal Description: N TR 1140 LOT 44
Owner: PERKINS SCOTT
Contractor:
Address: 3419 VIA LIDO #455
Address:
NEWPORT BEACH, CA 92663
$0.00
Phone:
Phone:
0
Con State Lic:
Issued Date:12/03/2019
Lic Expire:
0
Bus Lic.
Processed By: u
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
Fee :
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Project is l 1746-2019
E219-0800
GRAYSTONE CUSTOM BLDRS INC
3419 VIA LIDO STE 455
NEWPORT BEACH CA 92663
949-466-0900
971085
03/31/2020
BT30040057
03/31/2020
Inspection Requests Phone (949)644-3255
Code Edit: 2016
Worker's Compensation Insurances Gjo�
Carrier, STATE FUND oe qm✓
Policy No: 9216100¢¢
Expire: 08/15/202L�T
FEES
Receptacle/Switch/Outlets
$0.00
Receptacles/Outlets:
0
$0.00
$0.00
Fixtures:
0
$0.00
$0.00
Sep Circuits:
0
$0.00
$0.00
Low Voltage
0
$0.00
Over 100 HP/KW/KVA:
Signs
$0.00
Issuance Fee:
$0.00
Branch Circuit:
0
$0.00
$0.00
Each Add Circuit:
0
$0.00
$0.00
Time Clocks:
0
$0.00
$0.00
Additional Fee :
$0.00
Inspection Requests Phone (949)644-3255
Code Edit: 2016
Worker's Compensation Insurances Gjo�
Carrier, STATE FUND oe qm✓
Policy No: 9216100¢¢
Expire: 08/15/202L�T
FEES
0
$0.00
Motors/Transformers (HP/KVA)
0
0to 1 HP/KW/KVA:
0
0
00
1 to 10 HP/KW/KVA:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
Over 100 HP/KW/KVA:
0
$0.00
Piggy Back/Temp Power: 0 $0.00
Temp Power Pole: 1 $39.00
Check Fee :
Te id�rbround:
0
$0.00
el:
0
$0.00
\g1
0
$0.00
O
tlD
0
$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Issuance Fee:
$35.00
Supplemental Fee:
$0.00
e at Permit Issuance :
$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.
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JWNER-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)
(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 penalty 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 of proving that it was not built or
im 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
apply 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 Contractors' State License Law for the following reason:
By my signature below 1 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 legal
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent D to
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700) of Division 3 of the Busines rofess' n ode, and my license is in full force
and effect.
License Class License No Date i Contract ignatur
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER T CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU DRED THOUSAND DOLLARS ($700,000), IN ADDITION TO TH
COST OF COMPENSATION, DAMAGES AS PROwDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
Per -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 t
oklqrmance of the work for which this permit is issued. Policy No.
ve III 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' compensati,
Ins a carrier and policy number are:
is of Agent _
certify that, in the
. if I should bacon
nature of Applican
Policy Number
Date
Ice �for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' iTi ensation laws of California, and agre
o e worke eR p ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Dae /
%NSTRUCTION LENDING AGENCY
perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Address
my signature below, I certit� to each of the fo
I am the property owner o authorized to act
I have read this application and the informat
I agree to comply with all applicable city
I authorize representatives of this cit coli
nature of Prooertv Owner or Autho ed Agen
ACTION
CERTIFfC.4TE0F
OCCUPANCYISSDED
ow er's behalf. ?
BdJis correct.%
,as nd state to building construction. U� /
-i entified property =for pection purposes.
Print Property Owner's or Authorized Agent's Nam
BY DECLARATIONOF COMPIiANCEIMTHCODEOF FOR DFRCEEL
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❑ ASBESTOS NOTIRCATTOMIS NOT APPLICABLE TO
PROP(3,03EDDEMOLIT101I - - •,•
SIGNATURE,-