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Home My WebLink AboutE2021-0284 - PermitsCity of Newport Beach • Bu4lding Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 u Job Address: 1901 SABRINA TER Bldg: 1 Floor: Suite: Description of Work: ELEC/BBQ Inspector Area: 2 Legal Description: N TR 2813 LOT 120 Owner: PARKER ROBERT Contractor: Address: PO BOX 980 Address: CORONA DEL MAR, CA 92625 Phone: Phone: Con State Lic: Issued Date:04/28/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: II �IE II I II�I� 0�I I II��I III �I�III 0�I I II�II I II4 II PATTERSON CONSTRUCTION 15 CORPORATE PLAZA STEA50 NEWPORT BEACH CA 92660 949-723-1800 802367 07131/2022 ST02110534 09/30/2021 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: ' 1 $1.75 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over600V or1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Fee: $38.75 Electrical Permit: E2021-0284 Project No : 1174-2019 Inspection Requests Phone (949)644-3255 Code Edit: 2019 13 rn 0A Worker's Compensation Insurance Carrier: STATE COMP E Policy No: 9065406 Expire : 08/01/2021 03.] FEES Motors/Transformers (HP/KVA) 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: 0 $0.00 Plan Check 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 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 Saturd1y,,(rgrra 8:00 a.m. ®0 6:00 p.m. E £ 4 f 9 0 A G DO C DL4 O 4 O Z D D sD D o a D oc aoc a D o Duo G O D O D O D O O G 1 1 O< O P E C CC O < CC O `40 400 O D D4 94 444 OWNER -BUILDER DECLARATION 1 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 L) all of or L) 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 improved 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 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 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.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I 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 Code, and my license is in full force and effect. y License Class License No Dat Contractor SignatuK- WORKERS' COMPENSATION DECLARATION WARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED 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: ❑ 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 thr vitrance ormance of the work for which this permit is issued. Policy No. have and 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' compensation carrikkr a d policy nuyft-ft are: Expiration Date of Agent I certify that, in the pertormancelf 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 that, if I should become s/upject totheworkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provis Signature of ApplicantY // e '��/Z/ DECLARATION REG G CONSTRUCTION LENDING AGENCY I hereby affirm under i5bralty of 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 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 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 count ordinances and state laws relating to building construction. I authorize representatives of this city or coun t enterU above -identified property for inspection purposes. ✓1/1 Signature of Property Owner or Authorized Agent /!�( 10� Print Property Owner's or Authorized Agent's Na ✓ 1 ACTION �A BY ; • • • • ` • • • DECLARATION OF COMPLIANCE IMTH CODE OF FEDERAL REGULATIONSPART 61 OF TITLE40 AND AQMD RULE'1403, ❑ 1 SUBMITTED ASBESTOS NOTIFICATIONTO., ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: FOR OFFICE USE ONLY PERMITEXPIRED • . . . . . • . • PERMITC4NCELLED • • • • ` • PFRMfTFX7ENQEQ PERMIT FINAL '�'. .•. ',VJ I •• ••• •, CERTIFICATEOF OCCUPANCYISSUED • J. • • • • ✓-• • • • • • •