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Home My WebLink AboutE2021-0453 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 r"�tiruu�a . Job Address: 5009 SEASHORE DR Bldg: 1 Floor: Suite: Description of Work: ELEC- TEMP POWER POLE (X2019-4070) Inspector Area: Legal Description: OCEAN FRONT TR BLK 50 LOT 5 Owner: 5009 SEASHORE LLC Contractor: Address: 1 CORPORATE PALZA DR #110 Address: NEWPORT BEACH CA 92660 Phone: Issued Date:08/02/2021 Processed By: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over600V or1000A: 0 O/H to U/G 0 Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: 111111111111111111111p11111111111111111p111111111 JillElectrical Permit: E2021-0453 E 2 0 2 1 0 4 5 3 Project No : 2805-2019 LEGACY CUSTOM HOMES INC 1000 QUAIL ST, STE 220 NEWPORT BEACH CA 92660 949-887.4750 986194 08/31/2021 ST30045036 10131/2021 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 $0.00 Fixtures: 0 $0.00 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs $0.00 Branch Circuit: 0 $0.00 $0.00 Each Add Circuit: 0 $0.00 $0.00 Time Clocks: 0 $0.00 $0.00 Additional Fee : $0.00 37.00 pi.n Inspection Requests Phone (949)644-3255 Code Edit: 201-r9't�B , y �p®R° �1®C®�� 1 [�6d� B,®►v 11��ee Worker's Compensation Insu Carrier: OA Policy' 0 4�0ranc Expire : 12/02/2021 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: 0 $0.00 Fee : Temp Underground: 0 $0.00 Sub Panel: 1 $29.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Fee Due at Permit issuance: $67.00 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 6400 p m. � J tl J UD D D D DU-Dj0 D U 6 AdB OU�UU O`O BB�BJ�. YiJV 4'�i DWNER-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 iot more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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). ❑ 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 legall) 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 ection 7000) of Division 3 of the Business and Pro nsns Code, license " ' dill force and effect. Si �,- License Class License No Date 7' Contractor natur � g - 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 (t100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 th gpeance of the work for which this permit is issued. Policy No. nd 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' compensatiol ce carrier and policy number are: Policy Number Expiration Date Name of Agent Phone # 01 certify that, in the performance of the work for this permit is issued, I sll not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre hat, if I should become sub'a t to the workers' pensation pro ' ns of n 3700 of the Labor Code, I shall forthwith comply with those provisions. rr Signatureof Applicant Dam c�L //�:�sA7� DECLARATION REGARnNGtGNZNJPoMN LENDING AGE Y ✓ I hereby affirm under penalty of perjury that there is a constr ,' n 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. 1 have read this application and the information I have provided is correct. I agree to comply with all applicable city and coun ordinance and state laws relating t Ilding construction. I authorize representatives of this cityor count ty/tyenter t above-idenf ' o e o section purposes. , //' ,. Signature of Pro ertv Owner or Authorized Agerrl\ / _print Property Owner's or Authorized Agent's Name,/' 1 lCti K�L�L Date/�-! Z� ACTION DATE a �• BY UCa.cHresirtVlP VP w. +,. FEDERAL REGULATIONSPART0i OFTITLE40AND •` 'a—, :'AQMDRULE1403. 'I PERMIFEXPIRED „� Q ❑ 1 SUBMITTEDASBESTOS NOTIFICATION TO: • ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSEDD€MOLITION. PERMIT CANCELLED • "� • • y' i • ,'• PERMtTL7fTENDED • , •� PERMIT FINAL , • • • , CERAFICATEOF • ••• OCCUPANCYISSUED s e.•°�^eoV_�o=_nSIGNATt1RE:. A