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Home My WebLink AboutE2020-0420 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newpon Beach, CA 92660 (9) Permitounter Phone (949)644-3288 Job Address: 1017 SANDCASTLE DR Bldg: 1 Floor: Suite: Description of Work: ELEC -TEMP POWER POLE (X2020-1823) Inspector Area: 4 Legal Description: N TR 6425 LOT 78 Owner: PEDERSEN NIELS & STEPHANIE Contractor: Address: 1017 SANDCASTLE DR Address: CORONA DEL MAR CA 92625 Phone: 949-228-2833 Phone: Con State Lie: Issued Date:08/13/2020 Lie Expire: Bus Lie: Processed By: Lie Exp Date: IIIII11111111111111111II1III1IIhi11111II1IIII S CORNERSTONE CONSTUCTION 15540 ROCKFIELD BLVD STE A 110 IRVINE, CA 92618 949-369-1979 1033864 12/31/2021 BT30061583 12/31/2020 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 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTALFee: Electrical Permit: E2020-0420 Project No : 2842-2019 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: ACCREDITED SURETY & CASUALTY Policy No: 1ATCA16211 Expire: 1112212020 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: 1 $41.00 Fee : CTUK t `� L. 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 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPEC77ON 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• o� a I hereby affirm under penalty of perjury mat i am exempt from file Contractors' State Ucense Lav✓ for the neas ins) indicated below by the checkmard(s) I have placed next to the applicable fiern(s) Section 7091.5, Business and Piofasslons Code: Any city Or counly that requires a permit to construct, alter, improve. demolish, m repair any structure, pier 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 "a Contractors' State License law (Chapter R (commencing with Section 7000) of Derision 3 of the Business and rrofesskms Cede) or mat he or she is exempt tmm licanSUTR and the basis' orthe alleged exemption. Any violation of Section 7031.E by any applicant Tor a pernVI subjsots the applicant, to a civil penalty or lot more than five hundred dollars ($500). I. as Omer of the property, or my emptoyeaswi`h wages as their sole compensation, wild. do (_) ail of or t! portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness and Professions Code' The Contractor' State ticense Law does not apply to an owner of property who, through employees or personal effort, builds or improves me property, provided that the Tprovements are not intended or offered for sale. R. however, the building or improvement is sold tvithm One year of completion, tlta Owner -Builder MH have the burden of proving that if was not bUilt or n roved for fie purpose of sale). 1, as owner of the property, am excfusrvery contracting wan licensed Contractor, to construct the project (Section 70441, Business and Professions Code: The Contractors' Stet; License taw does not OJply to en owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Lawt. 1 am exempt from licensure under the Contrackr5' State Ucense Law for the following reason: ly my signature below f acknowledge that, except for my personal residence In which I must have resided for at least one year pnpr to completion of the imp ovamenls covered by this pemlt.. I cannot Iegalf .ell a structure that i have built as an owner -builder if R 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 'mfessidns Code, is available upon request when this application is submitted or at the following Web 5rta:httpt:WAvw.fegiNo.ca.gcvicalaw.html. signature of Property owner or Authorized Agent Date .LCENSED CONTRACTOR'S DECLARATION hereby affirm underpenahy of perju that ) am licensed under provisions of Chapter 9 -,ommen4irg with Section 7000 of Division 3 of the Business and Profession- Code, and my license ism. fun force Ind effect License Class License No �j FS(s c-I Da l° j'?�. J> 20 Contractor Signatur�til4� VORKERS' COMPENSATION DECLARATION rARNMG: FAIMETO SECURE WORKERS' COMPENSATION COYERA io S UNLAWFUL AND SHALL SUBJECT AN EMPLOYERTO CHMRUL PENALTIES AND MIL FRIES UP TO ONE HUNDRED THOUSAND DOLLARS(000e0D. M ADDRION TOTHE p5r OF COWER MAGES AS PROVIDED FOR M SECTION VM OF THE LABOR COOL RMERE5r, AND ATTORNErS FEES hereby affirm Ity W perjury one of the following declarations: Mom a certarcate of consent to self.msn a for worfiers compensation, issued by the Director of mdustnal Relations as provided for by Section 37 , of the Labor Code, for e workforwhich this permit is issued. Policy No. 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. cry workers' compensa comer and policy number are: Policy Number of Agent Date certify that, In the performance of the work forwhich this permit is issued. I shah Pot employ any person in any manner SO as to become Sul)3KI to the workers' compensation: taws _M California, and afire . if t should become Subject t the NDYKer' ClJymper�Satlon provisions of Section 3700 of the Labor Cod@, I shall forthwilb comply With those provisions. Tatum of Appflcani l (�'� Dal Name AOOreSS of the work foT which this permit is Issued!Seciion 3097, Civil Code), my signature Delow, i Comfy ro seen or me mnowi g: I am the property Owner or authorized to act on the property owners behalf. I have read this application and the information 1 have provided Is correct f agree to comply with all applicable city and county ordinances and stale laws rotating to building construction I authorize representatives of Phis City or counir -,9 emet�he above-identi iVe property for inspection purposes. CER77FIC4ro OF OCCUPANC ISSUED REGULATIONS PART el OF TITLE 40 AND AQMD RULE. ••• • • • ••• •• • e m s• s• n e • s s s e o e e e oe e c o -- APPLICABLE TO