HomeMy WebLinkAboutE2022-0644 - Permits (3)City of Dewpportt Dpament-Building DivisionElectrical
100 Civic Center Dnve, Newport Beach, CA 92660Plan
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
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Permit :E2022-0644
Check NO
Work Class: Other
Issued Date: 09/15/2022
Inspection Area : 2
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 : 20 LINDA ISLE L1 gigval Desc
N TR 4003 BLK OT 20 TR 4003. LOT 20 AND POR LOT C
Description: ELEC: INSTALL (2) 110V OUTLETS WITH NO DEDICATED CIRCUITS AND 60A V CHARGER (WALL CONNECTOR)' 10/04/22 REVISE TO 60A EV CHARGER'
Owner: KENT J ROGER TRUST
Contractor : THE ELECTRIC CONNECTION
Address : 20 LINDA ISLE NEWPORT BEACH, CA 92660
Address: 9937 COMMERCE AVENUE TUJUNGA, CA 91042
Phone:
Phone: (818)446-0888
Con State Lie : 406002
Applicant: BEN MEDINA
Lie Expire : 09/30/2023
Address : 31225 LA BAYA DR WESTLAKE VILLAGE, i CA 91362
Bus Lie: `. BT30073295
Phone: (818)736-7876
Bus Lie Expire:10131/2022
Workers' Compensation Insurance
Owner/Builder:
Carrier: ':. INS CO OFTHE .WEST
Address :
Policy No: WVE505631102..
Phone:
W. C..Expire: 7/1/2023
Code Edition : 2019
Fire Hazard Zone :- NO
Type of Construction :
Occupancy Groups : R3/U
Building Setbacks : Front: 10, Front: 25, Side: 4, Side'.4
Flood Zone: AE, 8 FT; X
Use Zone: R-1 - Single -Unit Residential
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SPECIAL CONDITIONS:
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[hereby affirm under penalty of perjury that tam exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable !rare($)
action 7031S, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve: demolish, or repair any structure, priorto Its issuance, also requires the applicant. for
permit to file a signed statement that he or she is licensed. pursuant to the provisionsof the Contractors' State License Law (Chapter9 (commencing with Section 7000) of Division 3:of the Business and
Ifesslons Code) or that he or she is exempt from 1)censureand the basis for the alleged exemption. Any violation: of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of.
more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L,) portions of the we k, and the structure is not Intended or offered for sale (Section 7044,
siness and Professions Code; The Contractors' State License Law does not apply to an owner of property who, through employees'. or personal effort; builds or Improves the property, Provided that the
movements are not Intended or offered for sale. if, however, the building or improvement is sold within one year of completion,. the Owner -Builder will have the burden of proving. that it was not built or
)roved for the purpose of sale).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project. (Section 70", Business and Professions Code;. The Contractors' State License Law does not
Ay to an owner of property who builds or improves thereon, and who: contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from Iicensure under the Contractors' State License Lawfor the following reason
my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year p or to completion of the improvementsCoveredby this. permit, I cannot legal
I a structure that I have built as an owner-buildor if it has not been constructed in its entirety by licensed contractors. I understa d that a copy of the applicable law, Section 7044 of the Businessland
Alessions Code, is available upon request when this application is submitted or at the following Web sitw.http:/Iwww.leginfo.co.dov/calaw.htmi.
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 f r " ' 3 of the Business, Profs$ ,and my license is in full force
Ind effect. License Class License No Date Contractor Signature
NORKERS' COM'.PENSATION DECLARATION
DARNING: FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL: AND SHALL 3U9lECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE MUNaREO THOUSAND DOLLARS ($10%0001, IN ADDITION TO THE
:DST OF COMPENSATION, DAMAGES: AS PROVIDED FOR IN SECTION 37N OF THE LABOR CODE, INTEREST, AND ATTORNEY'SFEE&
hereby affirm under penalty of perjury one of the following declarations:
( have and will maintain a certificate of consent to self -insure for workers' compensation, Issued by the Director of Indu (net Relations as provided for by Section 3700 of the Labor Code, for the
ierformance Of the work for which this permit is issued. Polley. 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' -compensatior
z
ce carrier and policy number are
.arrler Policy Number Expiration Date
Jame of Agent. Phone #
:11 Certify that, in the parlor a of the r which this permit is issued. I shall not employ any person in any manner so as o become subject to the workers' compensate la s of California. and agree
Rat, if should banana as eat to th r ers' compensation provisions of Section 3700 of the Labor Code: Eshali forthwith aom ly with those provisions. I
signature of Applicant _ _ Date��_„__l
3EGLARATlp. DING STRUGTION LENDING AGENCY I
hereby air. d of perjury thatthere is a construction lending agency for the performance of the work forwtiich: this i}ermit is issued (Section 3097, Civil Cade),
.enders Namt•' Lenders Address
'jygry4signatur:��l �w, I certify to each of the following) -
13ni the gip• :�i owner of Authorized to act on the propary wner's behalf.
*have read th}a application and the Information 1 have pr ided Is correct-
• • 4 agree to. comply with all applicable city and caunty finances and state laces relating to building construction. P f
1 authorizg 7d'p%FVntatives of this city or county to arrte4.1beabove-ideniih property for inspection purposes, j q t I)J f y i..l I /I AO
A"O_N --- :
DATE
CERNNTEXPIREN ••
��,R -1-CANCEMfD
P�IyV?T EXPENDED
PERMIT FINAL
CERTrFICATE OF
OCCUPANCY ISSUED
i7
OF COMPLIANCE WITH CODE OF FEDEI
PART 61 OF TITLE 40 AND.AOMD RULE
1403
LJASAE$10S NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION