HomeMy WebLinkAboutE2022-0624 - Permits�EWPo� City of Newport Beach IIII I I II I II I II II II I I II II
OF � Community Development Department- Building Division Electrical Permit
> 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
= Permit Counter Phone: (949) 644-3286
Inspection Requests Phone: (949) 644-3255 Work Class :Other
°gcrroa"�P newportbeachca.gov/inspections Issued Date:
Inspection Area : 1
E2022-0624
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 4206 RIVER AVE Legal, Desc : A TIR CANAL SECTION BLK242: LOT 4
Description: ELEC -DISCONNECT DFOR MINI -SPLIT CONDENSER INSTALLATION
Owner:
BENSON NUEL C TR BENSON TR
Contractor : RIGHTIME HOME SERVICES
Address :
4206 RIVER AVE NEWPORT BEACH, CA 92663
Address : ' 1821 MCGAW AVE IRVINE, CA 92614
Phone:
Phone: ,(714)998-4300
Con State Lic : 765074
Applicant:
BEN MEDINA
Lic Expires 06/30/2023
Address :
31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362
Bus Lic : BT30078653
Phone:
(818) 735-7876
Bus Lic Expire:05131/2023
Workers' Compensation Insurance
Owner/Builder : Carrier : LIBERTY INS CO
Address: Policy No WA763D508631011
Phone : W. C. Expire: 101112022
Code Edition ; 2019 Fire Hazard Zone : N
Type of Construction : `Occupancy Groups : R3/U
Building Setbacks : Front: 4, Front: 20, Side: 3, Side: 3
Flood Zone: AE, 8 FT; X
Use Zone: R-2 - Two -Unit Residential
PROCESSED BY:
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I hereby affirm .under penalty of perjury that 1 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 hernia)
clion 7031,5. Business and Professions Code: Any city or county that requires a'permit to construct, alter, improve, demolish, or repair anystructure, prior to its Issuance, also requires the applicant for
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter9 (Commending with Section 7040) of Division 3,o€ the Business and
fessions Code) or that he or she is exempt from licensurs and the basis for the alleged exemption. Any violation of Section 7031.5 byarfy applicant fora permit subjects the applicant to civil penalty of
more than five hundred dollars. 1$500).
I, as owner of property, or my employees with wages as their sole compensation, will do U all of or U portions: of the work, and the structure is not intended or offered for sale (Section 7044,
,tress 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
rovements 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 [he burden of proving that it not built or
roved for the purpose of sale).
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.
ply 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).
I am exempt from licensure under the Contractors' State -License Law for the following reason: _
my signature below t acknowledge that, exceptfor 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
a structure that I have built asan owner -builder if it has riot been' constructed in its, entirety by licensed contractors, I understand that a copy of the applicable law, Section 7044 of the Business and
In under
License
COMPENSATION DECLARATION
der provisions of Chapter
License No
IARNINO: FAILURE TO SECURE WORKERS' COMPENSATION OCIVERArE 18 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS (St W.000), M ADDITION To THE
'DSTOF COMPENSATION, DAMAGES AS PROVIDED FOR M SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES',
hereby affirm under penalty of perjury one of the followingdeclarations:
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, forth+
e rmance of the work for which this permit is issued. Policy No,
I ave 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' compensaUor
rs nce carrier and. policy number are:
certify that, in the performance
if I should become supjgf,1.1Q=
affirm
Name
Policy Number
Date
for which this permit is issued. I shall not employ any person in any manner so. as to become subject -to the workers` compensa'onlaws of California, and agre!
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I
Dat
tN LENDING AGENCY /
re is a construction fending agencyfor the performance of the work forwhich this permit_ is; issued (Section 3097, Civil Code)..
my signaturebelow, I certify to each of the following:
I am the property owner or aulharized to act on the property owner'sbehalf.
I have read this apptication and the information I have provided is correct.
I agree to comply with all applicable city and county ordin s-end-state Is
I authorize representatives of this city or county to r tha above -identifier
OF
PERMIT EXTENDED
'HCODEOEFEDERAL. I FOR OFFICE USE ONLY
AND AQMD RULE
C€RTIFICATt QF �I t�'L%,? JD\ I PROPOSED DEMOLITION
IS NOT APPLICABLE TO
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