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Home My WebLink AboutE2022-0324 - Permits,.wnrr, City of Newport Beach - Building Division tee. d 100 Civic Center Drive, Newport Beach, CA 92660 r, Permit Counter Phone (949)644-3288 �tauzi - Job Address: 1221 BERKSHIRE LN Bldg: 1 Floor: Suite: Description of Work: ELEC - BBO Inspector Area: Legal Description: N TR 3031 LOT 18 Owner: PHAN PHUOC Contractor: Address: 3 GRASS VALLEY Address: IRVINE CA 92602 Phone: 714-478-7334 Phone: Con State Lie: Issued Date:05/27/2022 Lie Expire: Bus Lie: Processed By: Lie Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 200A: 0 0-600V over200A: 0 Over600V Or1000A: 0 O/H to U/G 0 TOTAL Fee: II�IE II IIIII 0II III III ill��l III' IIIII IIIII III II ALTERA LANDSCAPE 34145 PACIFIC COAST HWY #172 DANA POINT CA 92629 866-872-2611 893827 04/30/2023 ST30078844 O5/31/2023 Electrical Permit: E2O22-0324 Project No : 1393-2022 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: OAK RIVER INS CO Policy No: URWC205835 Expire : 11/07/2022 FEES . - : -.erg a Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 2 $3.50 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 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: 0 $0.00 Issuance Fee: $38.00 $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- Friday7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. ° °°° ° •a ... a a,• •. 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 :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 Drofessions 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 iot 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, 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). ❑ 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 legal) 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 appli able 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 affiml under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and/pro eses s ode, 'my license is in full force and effect. 1)/2 2- License Class License No Date Contractor Signature wl WORKERS' COMPENSATION DECLARATION NARNING: 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 ATTORNETS FEES. hereby affirm under penalty of perjury one of the following declarations: ❑J,6r9ve 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 or ance of the work for which this permit is issued. Policy No. eve 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' compensation carrier and policy number are: Policy Number of Agent Date 11 certify that, in the perf ma ce f th rk fo ich 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 agret lat, if I should become su je th ers' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of ApplicantZk Date .S /L7 /2 Z iECLARATION REGA I O UCTION LENDING AGENCY 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 (Se on 3097, Civil Code). Ender's Name Lender's Address y 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 rovIded is - ct. I agree to comply with all applicable city and cou y or Inance state s relating to building construction. I authorize representatives of this city or county jo e r the a -id ' ad property for inspection purposes. /!� / � ^ Date 12 7 /L 1-- ianature of Prooertv Owner or Authorized Ag Print Property Owner's or Authorized Agent's Name G/ ( (�� ACTION I 17A.TE I BY PERMIT EXPIRED • • • • • • i PERMITCANCELLED • ••• ° PERMITEXT€LADED • • •• • �• PERMIT FINAL CERTIFICATEOF • • ° OCCUPANCYISSUED • �• . ° _ • : ° e ° ° FEDERAL REGULATIONS PART 51 OF TITLE40 AND AQMD RULE 1403, ❑ I SUBMITTED ASBESTOS NOTIFICATION TO:. ❑ EPA ❑ AQMD ❑ ASBESTOS NOIIRCA710MISNOTAPPLICABLE TO PROPOSED.U€MOLITION. SIGNATURE.,