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Home My WebLink AboutE2021-0655 - Permitsr a City of Newport Beach - Building Division IIIIII111111111i 111111111111111i 111111111111 II Electrical Permit: E2021-0655 100 Civic Center Drive, Newport Beach, CA 92660 P Project No ,t; Permit Counter Phone (949)644-3288 s:, r't�s„v.a Inspection Requests Phone (949)644-3255 Job Address: 3520 DAFFODIL Bldg: 1 Floor: Suite: Description of Work: ELEC -DISCONNECT FOR A/C INSTALLATION (REPLACE EXPIRED E2019-0419) Inspector Area: 6 Code Edit: 2019 Legal Description: TR 11949 LOT 1 UNIT 21 OF PROJECT LOCATED ON AP 458-652-11 TOGETHER GO Owner: PEPPER ENTS Contractor: OWNER/BLDR Worker's Compensation Insurance Address: 11 HARBOR RIDGE DR Address: GRAASSJEFF Carrier: �$�°•• NEWPORT BEACH, CA 92660 Policy No: °rm °°°®•� Phone: Phone: 949-719-0754 Expire: • ° Con State Lie: O/B . ° Issued Date:09/30/2021 Lie Expire: ° °. Bus Lie: • m ° Processed B Y LicExpDate: oaa°• 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 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 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 FEES 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 Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee : Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental 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 Saturday from 8:00 a.m. to 6:00 p.m. ° a ° m m m °g ° V m sotir 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 $38.00 $0.00 INER-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 applicantfor 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 Iicensure 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 U 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). 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 ly 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). J I am exempt from Iicensure under the Contractors' Stat ly my signature below I acknowledge that, except for my ell a structure that I have built as an owner -builder if it h 'rofessions Code, is available upon request when Is a of Iignature of Property Owner or Authorized Agent .ICENSED CQV.TFACTOR'S DECLARATION hereby af6rm�un de rITenalty of perjury that I am licensed u nd effect. Imh52 Class_" . License No anse Law for the fallowing reason: al residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal I en constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 pf the B iness and Ais submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. / G 12 A% 0 A h / provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force Date Contractor Signature ERS' cbMPENSATION DECLARATION :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 I$100,000I, IN ADDITION TO THE COMPENSATIOII, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. affirm aederpenalty of perjury one of the following declarations: ve and.41 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 ante of thA Mrk forwhich this permit is issued. Policy No. Wave 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' ranCe carrigtanddiplicy number are: 01. .. . Policy Number Expiration Date ,Qrf A�Pnt_- Phone # 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date CLARATION REGARDING CONSTRUCTION LENDING AGENCY areby 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). ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on t&prortyer's behalf.I have read this application and the information Is correct. I agree to comply with all applicable city and couand state laws relating to building construction. I authorize representatives of this city or counrWve-identified property for inspection purposes. 1 mature of Prooertv Owner or Authorized AoenV Print Property Owner's or Authorized Agent's Name J Date ACTION DATE 1 E BY DECLARATION OF COMPLIANCE tMTN CODE OF FUR OFFICE USE ONLY FEDERAL REGULATIOMSPART 61 OF TITLE 40 AND AQMDRULE 1403. PERMITEXPIRED ❑ I SUBMfTTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTEN➢ED El PROPOSED TDEMOLI OS ONNOTTiON IS NOT APPLICABLE TO PERMIT FINAL 1— aj..22 ()>`. � CERTIFICATEQF SIGNATURE. OCCUPANCYISSUED