Loading...
HomeMy WebLinkAboute2021-0372 - Permits0 City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 115 41ST ST Bldg: 1 Floor: Suite: Description of Work: ELEC -TEMP POWER POLE Inspector Area: 1 Legal Description: RIVER SECTION BLK 41 LOT 21 Owner: OVERFELT SHEA & BRENT Contractor: Address: 1919 PORT PROVENCE PL Address: NEWPORT BEACH CA 92660 Phone: Phone: Con State Lie: Issued Date:06/16/2021 Lie Expire: Bus Lie: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over600V or1000A: 0 O/H to U/G 0 TOTAL Fee: E 2 0 210 3 7 2�� II A/0 6� SAILHOUS ES INC FV1v Worker's Compensation Insurance NEWP RT BEA R 0260 ®®�Y� /1C-olicy No: WSD60526440Carrier: INSURANCE COMPANY OF THE WEST 949-281-6045 7)A Expire : 1212912021 1007531 09/30/2021 BT30036603 Electrical Permit: E2021-0372 Project No : 0304-2021 Inspection Requests Phone (949)644-3255 06/30/2021 Code Edit: 2019 FEES Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 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 a 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: 1 $41.00 Issuance Fee: $37.00 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 Plan Check Fee: 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. ° 0 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 he 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 'mfessions 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 (_) all of or U 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). 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 Code, and my license is in full force nd effect. icense Class License No Dat 40z ( Contractor Signal u%� ✓— VORKERS' COMPENSATION DECLARATION DARNING: 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 DST 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: 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 Ice of the work for which this permit is issued. Policy No. 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' compensa carrier and policy number are: Policy Number of Agent Date certify 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 t, if I should becomes a bject to thew rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant /� A«�_ Date/ CLARATION RE(o'k1 D f G CONSTRUCTION LENDING AGENCY UN Ireby affirm under penalty 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). Iders Name Lenders Address 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or cou to ant�ejh/e a e-identified property for inspection purposes. V © L nature of Property Owner or Authorized Agent L�� 1----- Print Property Owners or Authorized Agent's Name �9 L'oJ� ��'�Wn Date ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 61 OFT17LE40AND AQMD RULE 141)3. •�• PERMfTEXPfRED ❑ ISUBMFTTEDASBESTOSi�iFI&i T12:. �•: • ❑ EPA • •. •• ❑ AQMD • •• •,• •, PERMITCANCEIIEO PERMITEXTENDED ❑ ASBESTOS NOTIRCA710MISNOTAPPLICABLETO PROPOSED DEMOLITION. •e • •e • •• PERNIITRIVAL L CER71FICATEOF OCCUPANCYISSUED ° • ^ : a SIGNATUREo e ° • • ° • e