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E2020-0041 - Permits
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City of Newport Beach - Building DivisionJill JillElectrical Permit: E2020-0041 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 0 4 1 Project No: 2994-2018 s 1 '�, �, Permit Counter Phone (949)644-3288 U yam, 45 ��i�,�¢,,-�� Inspection Requests Phone (949)644-3255 Job Address: 1235 SANTIAGO DR Bldg: 1 Floor: Suite: Description of Work: ELEC/PIGGY BACK 2994-2018 Inspector Area: 3 Code Edit:2016 Legal Description: N TR 3851 LOT 43 LU Owner: DESILVA CHRIS & JENNI Contractor: LEYVA ROBERT CONSTR CO Worker's Compensation Insurance Address: 1235 SANTIAGO DR Address: 953 UNION AVE Carrier: NO EMPLOYEES NEWPORT BEACH, CA 92660 COSTA MESA CA 92627 Policy No: s� GO Phone: Phone: 714-3235820 Expire Con State Lic: 825124 Issued Date:01/22/2020 Lic Expire: 09/30/2021 Bus Lic: BT30039303 Processed By: Lic Exp Date: 06/30/2020 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over600V or1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Fee: 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: 1 $39.00 Temp Power Pole: 0 $0.00 Plan Check 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 : PERMITS EXPIRE 130 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. o e a a e a � • o o o a a e •� �e e� • o® o0 0 o O� �• 0 0 • • e o 0 s • e • • a ©no ae oa o e eee ee )WNER-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 'rofessions 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved for the purpose of sale). 1 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 pply 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legall, ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. lignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION 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 Professio, ode, and my license is in full force end effect. .icense Class License No Date ' �2-2 O Contractor Signature I've VORKERS' COMPENSATION DECLARATION - IARNING: 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 DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: 7 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 th erformance of the work for which this permit is issued. Policy No. have 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 carrier and policy number are: Policy Number Expiration Date TIe of Agent 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 agre P, if I should becomes sect to ork co�p'enssation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature �f nature of Applicant 7�. -y / Dal( Z Z " i-V DL CLARATION REGARD1111113 CONSTRUCTION LEADING AGENCY rreby 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 the property owners 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 state laws relating to building construction. I authorize representatives of this city or county tQAter J"9 'I tifieq property for inspection purposes. AC77ON DATE BY DECLARATION OF COMPLIANCE MTH CODEOF MR' USEONLY FEDERAL REGULATIONS PART 01 OF TITLE40AND AQMD jzj14E 14Q3• Q y supM/Tr€D;SB*E*sraS MhFlIC'rulON TO: • •� PA • • AQMO • • e •• PERMITEXPIRED PERMITCMVCELLED DERMIT EXTENDED • ❑ ASBESTOS NO17FICATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION, • • see • e e e e • PERMITFINAL CERTIRCATE OF OCCUPANCYlSSUED AgURE: • s • • e SIGNe • • ss oe