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Home My WebLink AboutE2022-0001 - Permits0"oiVit City of Newport Beach - Building Division *E2022-0001* 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 _ Job Address: 20092 ORCHID ST Bldg: 1 Floor: Suite Description of Work: ELEC/TO BBQ Inspector Area: 3 Legal Description: N TR 1500 LOT 45 Owner: AYOUB CHRISTINE Contractor: Address: 7911 IRWINGROVE DR Address: DOWNEY CA 90241 Phone: Phone: Con State Lic: Issued Date:03/18/2022 Lic Expire: oof Processed By: t'7, Bus Lic: Lic Exp Date: Electrical Permit: E2022-0001 Project No : 0006-2022 Inspection Requests Phone (949)644-3255 Code Edit: 2019 POOL ICONS INC/ADAN Worker's Compensation Insurance 15935 DEL PRADO DR Carrier: STATE COMPENSATION INS FWND °' •°° HACIENDA HEIGHTS CA 91745 Policy No: 9268030 562-455-8883 Expire:0111612023 O „-- °' •°• 479446 10/31/2023 °° • ST30077496 • °°°°• 12/31/2022 O YC New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 2 $3.50 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 TOTAL Fee: 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 Check Fee: 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: $38.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance: 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. WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(sl) 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 ie 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"be-Business and rofessions Code) or that he or she is exempt from Iicensure 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 oknalty of )t more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness 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 iprovements 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 iproved 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 pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contri ctor pursuant to the Contractors' State License Law). ] I am exempt from Iicensure under the Contractors' State License Law for the following reason: y my signature 6g1511rj 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 e11 a structure t" 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 rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ignature of PrppeIV.11wner or Authorized Agent Date TGERSED COIJTRACTOR'S DECLARATION herg6y affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7060) of Division 3 of the Business and Profes s Code, and my license is in full force Rcl effect. ...... Q iceRse Class License No Date x��l9-7Lontractor Signature �'r(J 110RKJERS' @OMPENSATION DECLARATION ARMING: 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 Q,%,Ti(1FJCOMPENSA14ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hErebZaffirm V111clppalty of perjury one of the following declarations: 201-tsxe and wit 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( pVanance o.t6e w%for which this permit is issued. Policy No. !. all .. 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' compensatior Isurance carrier and policy number are: I Policy Number Date m of Agent )IeA� I V v v I I vnone � certify 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant CLARATION REGARDING CONSTRUCTION LENDING AGENCY ;reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work i lder's Name Lender's Address 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 ordinanc nd state laws relating to building construction. I authorize representatives of this city or county, tenter the ove-ide tified Er2EartAfrrr>pection purposes. of Property Owner or Authorized Agent Date this permit is issued (Section 3097, Civil Code). ACT70N DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 51 OF TITLE 40AND AQMD RULE 1403 ❑ ISUBMITTEDASBESTOS AAtO77FICATION TO: ❑ EPA ❑ AQMD' PERMITEXPIRED PERMIT C4.NCELLEO PERMITEXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMIT ANAL _7. CER7IFIC4TEOF OCCUPANCYISSUED