HomeMy WebLinkAboutE2021-0721 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111111111111
e d 10D Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 7 2 1
,Permit Counter Phone (949)644-3288
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Job Address: 1334 HAMPSHIRE CIR Bldg: 1 Floor: Suite:
Description of Work: SFR ELEC FOR BBQ (S2021-0187) **CHANGE OF CONTRACTOR**
Inspector Area:
Legal Description: N TR 3852 LOT 32
Owner: LANNI SCOTT
Contractor:
OWNER/BLDR
Address: 1334 HAMPSHIRE CIR
Address:
LANNI SCOTT
NEWPORT BEACH, CA 92660
O/B AUTH ATT
Phone:
Phone:
949-400-1557
Con State Lie:
O/B
Issued Date:10120/2021
Lie Expire:
.1I�1t"
Bus Lie:
Processed By: \ 1
Lie Exp Date:
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over 20OA: 0
Over 600V or 1000A: 0
O/H to U/G 0
Fee :
Electrical Permit: E2021-0721
Project No : 1877-2021
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier:
•
Policy No:
....
Expire:
o
•
°.°.
°°...
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
$O.a6 °
$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 BackrFemp 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
Fee Due at Permit Issuance :
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.
7WNER-BUILDER DECLARATION
1 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 It�ie 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
Sot more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U 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
oved 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
ply 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 his not been cons tryyyctEd 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 t¢is q¢pli ion i�4ubmy4j or at following Web site:http://www.leginfo.ca.gov/calaw.html. / `� Zo 2- 1
Signature of Property Owner or Authorized Agent ® Y' = Date 6— /�
LICENSED'CONikACTOR'S DECLARATIOB,/
I hereby affirm WVgr 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-&I`ect.
Lic�V,.ys�,e� Class License No Date Contractor Signature
4Q1tkERS' a 0MPENSATION DECLARATION
h'AR4;ING: FAILHRE 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 COMPERthTIOA, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirrrj bl`kMyenalty of perjury one of the following declarations:
•
j,liave and*wil..l 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
B �IlojVance of A work for which this permit is issued. Policy No.
❑I have and will tnapltain 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
ipggljlice carrier and eolicy, number are:
QWl Gr' .: • • • • Policy Number Expiration Date
ie of Agent —rnone R
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.
ignatum of Applicant Date
IECLARATION REGARDING CONSTRUCTION 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 (Section 3097
Ender's Name Lender's Address
Iy 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 sta laws relating to building construction.
I authorize representatives of this city or county to en/der he bovpride Ified property for inspection purposes.
lignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's /ame
Civil Code).
2
ACTION
DATE
BY
DECLARATION OF COMPLIANCE lMTB CODE OF
FOR OFFICE USEONLY
FEDERAL REGULATIONS PART 51 OF TITLE40AND
AQMD RULE 1403.
PERA41T EXPI RED
❑ I SUBMITTED ASBESTOS NOTIFICATIONTO:.
❑ EPA
❑ AQMD
PERA41TCANCELLED
PERMfTEXTENDED
ASBESTOSEl
P OPOSEDDEMOLIT N RON IS NOT APPLICABLE TO
PERNRT FINAL
B�
CERTIF)CATEOF
SIGNATURE:.
OCCUPANCYFSSUED