HomeMy WebLinkAboutE2023-0019 - Permits�eWPoRr City of Newport Beach
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
U Permit Counter Phone: (949) 644-3288
nq��GO0.N�P Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/i nspections
111111111111111111111111111111111111111111111111111111Electrical Permit
Plan Check No:
Work Class: Other
Issued Date: 01/10/2023
Inspection Area : 2
E2023-0019
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 : 123 VIA ORVIETO
Description : ELEC A/C DISCONNECT
Owner:
JOHANNA STAPLE
Address :
2547 XANTHIA CT DENVER, CO 80238
Phone :
(303) 525-5843
Applicant: BEN MEDINA
Address: 31225 LA BAYA DR WESTLAKE
Phone: (818)735-7876
Owner/Builder :
Address
Phone:
Code Edition :
Type of Construction
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY
CA 91362
Desc : N TR 907 BLK LOT 526 TR 907 LOl
Address: 532
NELY1/2 LOT 527
PLUMBING •0000•
CT CORONA, CA 92880
9 0°°°.•
0
Policy No: 21221200002 „
W. C. Expire:: 12/112023
2022 Fire Hazard Zone : NO
Occupancy Groups:
Front: 0, Front: 4, Side: 4, Side: 4
X
R-1 - Single -Unit Residential
SPECIAL CONDITIONS:
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�a aaa9t��� 9
t hereby
I, as owm
iness and
rovementa
roved for the purpose of sale),
1, as owner oftheproperty,: am
lye to an owner of property who
I am exempt from licensureunA
exclusively contracting with licensed Contractors to construct the project {Section 7044,lSusiness and
builds or improves thereon, and who contracts for the projects with a licensed Contracto pursuant to th
r cr amp Antractors' State. License Law for the following reason:
W
Professions code: The Contractors' State License Law does not
e Contractors' State License Law).. .
isle full force it
!KCRS' ayMyQIA14SATFON DECLARATION
N : FAILURE TO SECCRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO Cft9NlNAL PENALTIES AND CIVILFINES UP TO ONE HUND THOUSAND DOLLARS ($t99A99); IN ADDITION TO THE
O GOMPEREATISN,DAMAOESASPROVIDED. FOR IN SECTION 3744 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES:
dry affirm unCer pawahy of perjury one of the following declarations:
• ......
ttiive and wll{ in
a Certificate of consent to: self -insure for workers': compensation, issued by the Director �f Industrial Relations Be provided for by Section 3700 of the Labor Code, for th
rmance of the r� for which this permit is issued. Policy No.
•.
,Vand wlll'm411#sin 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' eompansaUo
arr1•sP•.s'.arder artd policy number arc:
sr • • Policy Number. Exp€rattan Late
p.of e9ent • • • • Phone #
oc 4 that, i o thepo o . nee of thew ich this permit is issued, f shall not employ any person in any manne� so as to became subject to the workers' pensation laws of California, and ogre .
if I should War; s Ct to the wo ensation provisions D s ebor Code, I shall forthwith comply with those provisions. /O
Date
3ture of Applicant
TIO
bvv affirmNunder Denelty,. ertu o ere is a nst et
�bion lending agency for the performance of the work for which this pennit is issued (Section 3097, vi1 ode};.
Iamthe;
i have ree
I agree to
APPLICABLE TO
CERTittCATE OF
OCCUPANCYL5SLIEA
FOR