The URL can be used to link to this page

Home My WebLink AboutE2021-0275 - Permitsw City of Newport Beach - Building Division '. 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1221 BERKSHIRE LN Bldg: 1 Floor: Suite: Description of Work: ELEC-TEMP POWER POLE 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:04/26/2021 - Lie Expire: Bus Lie: Processed By: -Y —Lie Exp Date: @�E 2 0 21 0 27ill5��III CARNEY CRAIG BUILDERS 302 CALLE RICA SAN CLEMENTE CA 92672 949-683-0220 499864 1213112021 BT30041098 11/30/2021 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 Over 600V or 10DOA: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: Electrical Permit: E2021-0275 Project No: 2037-2020 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Workers Compensation Insurance Carrier: EXEMPT Policy No: No employees Expire: 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 Backrremp Power: 0 $0.00 Temp Power Pole: 1 $41.00 Plan Check Fee: INSPECTOR 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: $37.00 Supplemental Fee: $0.00 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. 40 o 0 .�, .mom . .. .. ... 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 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 not 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, 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). 1, 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). 0 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below 1 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 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. Signature of Property Owner or Authorized Agent Date 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. /q� !� n License Class t� License No CIq"IS�I-{ Date ('e L( Contractor SignatureXe till/ 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 ADDmON 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 IN performance 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 of Agent Date ify 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 t, � I should become subject to the workers' corpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant)( / C/y Z.B�(/( i Date CLARATION REGAh ING CONSTR19CTION LENDING A69NCY :reby 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 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 state laws relating to building construction. I authorize representatives of this city or county to a r the above -id ifie y for inspection purposes. ) inature of Properly Owner or Authorized Agen�L2/LA--LG/ (I Print Property Owner's or Authorized Agent's Name / XLYIIh � iZ.i�� Date / Z4 k ACTION DATE BY Ln=L.L l w I rutr t �UMr PUVr c rrr r n ruin yr FEDERAL REGULATIONSPART 5%OF TIV E40AW AQMD RULE 1403, •• PERMIT EXPIRED ❑ 1SUBMITT€DASB€STOS NdatiCATAOI*TO7• w•• ❑ EPA •.• : ••• ••. ❑ AQMD i ••• •• PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSEDDEMOLITION. • e • • • • i • i • s �� ... PERMITFINAL j —t CERTIFICATEOF SIGNATURE.,