HomeMy WebLinkAboutE2020-0721 - PermitsCity of Newport Beach - Building Division
ot` 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 404 BELVUE LN Bldg: 1 Floor: Suite:
Description of Work: ELE -TEMP POWER POLE (x2020-2923)
Inspector Area: 1
Legal Description: N TR 1090 LOT 29
Owner: POMA VICTOR
Address: 404 BELVUE LN
NEWPORT BEACH, CA 92661
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Contractor: CLAYTON BUILDERS INC
Address: 250 LUGONIA ST
NEWPORT BEACH CA 92663
Phone:
Phone:
949-279-5910
Issued Date:12/15/2020
Con State Lic:
Lic Expire:
846631
09/30/2022
Bus Lic:
�40
BT30043010
Processed By:
Lic Exp Date:
04/30/2021
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over20OA: 0
Over600V or1000A: 0
O/H to U/G 0
Receptacle/Switch/Outle
Receptacles/Outlets:
0
$0.00
Fixtures:
0
$0.00
Sep Circuits:
0
Low Voltage
0
Signs
$0.00
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee:
Electrical Permit: E2020-0721
Project No : 1821-2019
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Insurance
_,,)_P6Iicy No: NO EMPLOYEES
Expire :
014,
is Motors/Transformers (HP/KVA)
$0.00 0 to 1 HP/KW/KVA: 0 $0.00
$0.00 1 to 10 HP/KW/KVA: 0 $0.00
$0.00 10 to 50 HP/KW/KVA: 0 $0.00
$0.00 50 to 100 HP/KW/KVA: 0 $0.00
Over 100 HP/KW/KVA: 0 $0.00
$0.00
$0.00 Piggy Backfremp Power: 0 $0.00
$0.00 Temp Power Pole: 1 $41.00
$0.00
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
11 TOTAL Fee: $78.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $78.00 11
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.
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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
11 TOTAL Fee: $78.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $78.00 11
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.
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11 TOTAL Fee: $78.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $78.00 11
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.
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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 U all of or L) 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).
111, 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).
❑ 1 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 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.htmi.
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 (commencingwithSection 7000) of Division 3 of the Business a Profes 1 Code, license is in full force
and License
Cl ,�,,,/ �7i S ?�O Contractor Si r r
License Class License No " gnat
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 ADDITION 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 the
performance of the work for which this permit is issued. Policy No.
I 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' compensatio
insurance carrier and policy number are:
r Policy Number Expiration Date
P)ha
of Agent - Phone #
rtify 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
I should become subject to e o ers'.com n s/jlon pr/yv dons of Section 3700 of the Labor Code, I shall forthwith comply with those prov'sions. /
Signature of Applicant iu/jJ' V Da e C T//I 5L
DECLARATION REGA t G CONSTRUCTION L DING Od3ENCY
I 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, Civil Code).
Lender's Name Lender's Address
By 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 coun to nt a e ' en ' property for inspection purposes. j
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date6
ACTION DAB BY DECLARATION OF COMPLIANCE K9TIICODE OF FOR OFFICE USE ONLY
FEDERAL R€6l4¢j10N5 PART 61 01= TITLE 40AND
AQAID RULg 9409. • i • " • • • •
PERMfTIXPiRED
[3 ISUB�b9!TTEDAS$E57p51�14' .FlCAiY1M $Q,�`,
❑ E3'A ••• •. ••s • • s : i
❑ AOIygD • •
PERMIT CANCEllED
PER7vffFIXTENDED
❑ ASBESTOS NOIIRCATIONlSNOT APPLICABLE TO
PROPOSED D4A9DLTQON.
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PERMIT FINAL
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