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HomeMy WebLinkAboutEL120914_ELECTRICAL PERMIT Revision 1County of Orange OC Public Works (This permit will expire after 180 days of inactivity and the applicant is responsible for tracking and maintaining it active. For more information, visit our website.) Main Office 300 N. Flower Street Santa Ana, CA 92702 For Inspections Call: (714) 796-0407 or Visit us on the web at: http://www.ocplanning.net ELECTRICAL PERMIT Building Permit Number: EL120914 Revision 1 (Rev. Date: 2/21/13)Issue Date: 1/28/13 Description of Work/Use: Electrical for fireplace Issued By: Margo Orozco Rev Reason: PB/EL work includes: firepit, fireplace, bbq island and firepots, patio covers Work Authorized: PB:N ME:N EL:N Gas Meter:0 Elec Meter:0 Job Address: 92 Archipelago Dr, Newport Coast Owner: Ken and Maureen Shaw Additional Address: Address: 92 Archipelago Assessor Parcel No: 489-071-19 Newport Coast,CA Legal Description: 16407 4 TR Phone: 949-690-7874 Related Permits: PB120771 RS121113 RS121114 RS121115 RW120183 Contractor:BRAD KINNEY(Applicant)Architect: Address: 1560 Superior Avenue Su B3 Address: Costa Mesa, CA 92627 Phone: 949-548-3355 Phone: License#: 494601 Class: A,B,C27,C53,HAZ License#: Class: Attn: Brad Kinney Attn: By signing below, I certify to each of the following: I am(_)a California licensed contractor or(_)the property owner or (X)authorized to act on the property owner's behalf. I have read this contruction permit 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 authorized representatives of this city or county to enter the above-identified property for inspection purposes. CALIFORNIA 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. Contractor Name and Address: BRAD KINNEY 1560 Superior Avenue Su B3 Costa Mesa CA 92627License Class: A,B,C27,C53,HAZ License No.: 494601 OWNER - BUILDER'S 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 there 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 or portions of the work, and the structure is not intended or offered for sale (Sec. 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 build or improve for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.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 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: 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 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 (Sec. 3097, Civil Code). Lender's Name: None Lender's Address: None 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 the performance of the work for which this permit is issued. Policy No.9041153 I have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Insurance carrier and policy number are: Carrier: STATE COMPENSATION INSURANCE FUND PolicyNo: 9041153 Expiration:2014-01-03 I 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 agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Warning: failure to secure workers' compensation coverage is unlawful, and shall subject 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. By my signature below, I agree that this permit is issued on the basis of the information that I submitted and the County of Orange makes no representations regarding such information. I agree to indemnify, defend and hold harmless the County of Orange, its officers, employees and representatives from any claim or litigation arising from or related to the issuance of this permit or any actions taken on the basis of this permit.