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Home My WebLink AboutE2019-0613 - Permitst°ram City of Newport Beach - Building Division c ! 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �x Job Address: 501•- T14STIN AVE Bldg: 1 Floor: - Suite: Deseriptiortof Work: E@EC - TEMP POWER POLE (X2019-2743) C B 9J6P9 ' 66r 4 InspDOOorArea:_ ° 3 _ LGBP Legal Description!- ADD TO NEWPORT HEIGHTS BLK 35 LOT 24 11I111I11I1pll11l1l1111111p11ll111p1Jilit Electrical Permit: E2019-0613 E 2 0 1 9 0 6 1 3 Project No: 1390-2018 Inspection Requests Phone (949)644-3255 Owner: MOHkv-0 Contractor: KRS DEVELOPMENT Addrassi ' 0 501 TUSTIN AV Address: 2941 GRACE LN STE C `o NEWPEPRT- BEACH CA 92663 COSTA MESA, CA 92626 Phor'e", �� Pm o Phone: 949-290-6500 P. d Con State Lie: 912477 Q° Issued Date:09/04/26'rrr Lie Expire: 04/30/2020 Bus Lie: BT30044186 Processed 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 or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $74.00 -Lie Exp Date: 07/31/2020 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Plan I119S1 ECT® Code Edit:2016 Worker's Compensation Insurance Carrier: STATE COMP FUND Policy No: 9129520 Expire: 0513112021 Motors/Transformers (HP/KVA) 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 Backffemp Power: 0 $0.00 Temp Power Pole: 1 $39.00 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: $35.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance: $74.0 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. OWNER -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). ❑ 1, 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, 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,rovided 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 tRatlywas not byiiItyt roved or the purpose of sale). • •• imp 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;taqwe Law dyes not. apply to an owner of propertywho builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 11 ••u•• I 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 by41ri3 permit, I cannot leVally 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 of1haBusiness and' Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. ••. • •' 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 Profes i ns Cod �nd m license is in fIr11 f'occe and effect. q •Y,"• License Class License No Dat �— �� I Contractor Signatur •• •••••• WORKERS' COMPENSATION DECLARATION .ww NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE H NDRED THOUSAND DOLLARS (•'IB6%, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37BG OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES. hereby affirm under penalty of perjury one of the following declarations: 1 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 the keerformance 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' carrier and policy number are: Policy Number Expiration Date of Agent LII certify that, in the performance of the work for whiphtq 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 subject to the ers' compe Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. p. Signature of Applicant . DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby 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). 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 county ordinan es and state laws relating to building construction. I authorize representatives of this city or county to enter ab ve-id ied property for inspection purposes. �p- Signature of Property Owner or Authorized Ag Print Property Owners or Authorized Agent's Na a Iyw3) .9« Date AC77ON DATE BY OECI.ARATIONOFCOMPUANCE WTN CODEOF FOROMOPUSEONEY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMDRULE 1403. PERMITEXPIRED ❑ t SUBUTTEDASB€STOS M077FICATION TO; ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEX7ENDED ❑ AS6EST05 NOTIRCATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION PERMITFINAL CERTIF[CATEOF OCCUPANCYISSUED SIGNATURE;