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Home My WebLink AboutE2020-0680 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 E 2 0 20 0 6 80 II IE262-c - o (o U cavi;� Electrical Permit: E2020-0680 Project No: 1753-2020 Inspection Requests Phone (949)644-3255 Job Address: 18 CORMORANT CIR Bldg: 1 Floor: Suite: 0 $0.00 0-600V over20OA: 0 Description of Work: ELEC OUTDOOR OUTLET Over 600V or1000A: ITom NSPLU $0.00 O/H to U/G 0 Inspector Area: 3 Branch Circuit: 0 Code Edit: 2019 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 ° Legal Description: N TR 12529 LOT 9 Supplemental Fee: $0.00 b e° o • b G m• Owner: VOSS MELANIE& MICHAEL Contractor: OWNER/BLDR Worker's Compensation Insurance Address: 18 CORMORANT CIR Address: AUTH AGENT: Carrier: • ° ° NEWPORT BEACH, CA 92660 PAT SIMONIAN Policy No: m m Phone: Phone: 949-721-8585 Expire Con State Lic: 018 ° m m Ob b eo000 • Issued Date:11/25/2020 Lic Expire: Bus Lic: •o ° oboGOG Processed By: Lic Exp Date: 0000 OOGGGO ° G • ® mboo OGCO New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: Receptacle/Switch/Outlets Receptacles/Outlets: 1 $1.75 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs $0.00 10 to 50 HP/KW/KVA: Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 FEES 0 $0.00 Motors/Transformers (HP/KVA) 0 0 to 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 Backrremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee : Fee Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $37.00 Supplemental 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. 1NER-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) ction 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 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 fessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, ;iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or roved for the purpose of sale). yL as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exepW jrpill licensure under the Contractors' State Li Law for the following reason: mY signature beldw I acknowledge that, except for my pers al r sidence in ich 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal a.structurep that I.have built as an owner -build if' as t be construct in its entirety by licensed contractor . I understand that a copy of the applicable law, Section 70 of the Busing and fessions Ube, isavailable upon request when app' ub itte rat the followin Web site:http:// .leginfo.ca.gov/calaw.html. t I Nrture of Prqperty Owner or Authorized Agent i Date SENSED C$ONJ$ACTOR'S DECLARATIO :reby affim Untler:penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, an my license is in full force j%epse Clas$ ° : License No Date Contractor Signature VQj;XERS"CdMIPENSATION DECLARATION olil 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 ($700,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereiy affirm mrderpenalty of perjury one of the following declarations: �o ,I,;ITave and°uOiA 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 oPiH@Caork for which this permit is issued. Policy No. 11 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' compensatiol Isurance carrier and policy number are: Policy Number Date Name of Agent -i -none s I certify that, in the p=perjury rk for which t )' permit is issued, 1 shall not employ y person in any manner so as to become subject t th workers' compensation laws of California, and agre that, if I should becomrs' co ens tion provisions of Section 3700 of the L bor Code, I shall forthwith comply with those provi i Signature of Applicant Date ' ✓ w� DECLARATION REGATION LENDING AGENCY I hereby affirm under pthere is a construction lending agency for the performance of the work for which this permit is issued (Se do 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the propowner's behalf. 1 have read this application and the information I have rov' ed is L=1 t. 1 agree to comply with all applicable city and un rdin ces ane laws relating to building con truction. I authorize representatives of this city or cou t t ov d property for inspection pu poses.'l r' Pro Owner's or Authorized A ent's Nam I Un Signature of Pro ertOwner or Authorized AgenY IIACTION DAA BY FEDERAL REGULA TIONS PART 610 T!!ILE40AND CLARATION OF COMPUANCE 14f[TH CODE OF 7I \ FOR OFFICE tfSEONtY' FINAL ❑ I SUBMITTEOASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMO ASBESTOS MOTIRCA170H IS NOT APPLICABLE TO PROPOSED DEMOLITION. OCCUPANCYtSSU€D I I I SIGNATURE: