HomeMy WebLinkAboutE2022-0584 - Permitsa�WroRr City of Newport Beach IIII I I II I II I II III I I I II II Electrical Permit : E2022-0584
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-2176
> = Permit Counter Phone: (949) 644-3288 Work Class: Other 0
o- Inspection Requests Phone: (949) 644-3255
CqG/pnpN�P Issued Date : 0812912022
newportbeachca.gov/inspections Irai
Inspection Area : 6
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PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DIATL"
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREA
Job Address: 6 SUNDIAL Legal Desc : N TR 16461 BLK LOT 45
Description: ELEC: INSTALL ELECTRICAL FOR EXT SERVICE COUNTER, PIZZA OVER & FOUNTAIN (XR2022-2332)
Owner: COLBY WEAVER
Address : 6 SUNDIAL NEWPORT COAST, CA 92657
Phone:
Applicant: PAULELLISON
Address : 24642 VIA RAZA LAKE FOREST, CA 92630
Phone: (949)683-9861
Owner/Builder:
Address
Phone:
Code Edition : 2019
Type of Construction :
Building Setbacks
Flood Zone:
Use Zone :
PROCESSED BY:
X
PC - Newport Coast
Contractor: URBAN LANDSCAPE MAINTENANCE INC
Address : 895 DOVE ST 3RD FLR NEWPORT BEACH, CA W@D
Phone: (949)637-8767 ^^°^
Con State Lie : 962251 ° ° °
Lie Expire : 06/30/2023
Bus Lie: BT30079582 '
Bus Lie Expire:08/31/2023
Workers' Compensation Insurance
Carrier: TECHNOLOGY INSURANCE COMPANY INC "
Policy No: TWC4105863
W. C. Expire: 6/3/2023 ,.
Fire Hazard Zone: Y
Occupancy Groups : U
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reasnn(s) indicated below by the checkrnark(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
IS permit to file a signed statement that he or she is licensed pursuant to the previsions 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
of more than five hundred dollars ($500).
3 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,
lusiness 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
nprovements 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
nproved for the purpose of sale).
3 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044. Business and Professions Code: The Contractors' Stale License Law does noL
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: _
Iy my Sig natoto below I acknowledge that, axe apt for my personal residence In which I must have Tosidad for at least one year prior to completion of the Improvements covered by this permit, I cannot legall,
all a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed oaniracters. 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: httpaiwwwJeginfa. ca,gov/Calaw.htmi,
iignature of Property Owner or Authorized Agent _ Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of IVis n 3 of the Business and Professio s e, d to se is in full force
Hill effect. License Class License No Date h Zp 2L Contractar Signature �_
VORKERS' Z:OMPWNSATION DECLARATION
'ARNINJ: 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 (S100,000), IN ADDITION TO THE
OS, Ut COMPENSATION, DAMAGES AS PROVIDED FORM SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
F.l ' gave 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 Ih
p r ranee or ire wo'k for which this permit is issued, policy No.
ive 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' compensatioi
-, a carrier and policy number are:
a, c r Policy Number Expiration Date
P'aa.e Lf Agent Phone#
I'll cenify that,in the relmTrraoce of the k for f 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 agre
ll,at, G i should become bject ,rfiie oil rs t ease
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Appiant ,,,.�, „_ ,._. _.. Date
DECLARATfON REGA STRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code),
Lenders Name _ Lender's Address _
By my signature below, I cenify to each of the following:
I am the property owner or authorized to acton the property owner's behalf
I have read this application and the information 1 ovided is car .
I agree to comply with all applicable city and co my ordi ces a slat ws r a g to building construction. / ,e—
I authorize representatives of this city or count the abo a-i tified art for inspection purposes. ( y 9
Signature of Property ed Owner or AuthorizA ent Print Properly Owner's or Authorized Agent's Name / (�/1 L / 1' Date 2
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL. FOR OFFICE USE ONLY
-REGULATIONS PART 61 OF TITLE. 40 AND AQMD RULE
1403
PERMIT EXPIRED LJtSUBMIMDAS8ESTOSNOTlFIC.ATiONTO
PERMITCANCELLEO EPA - All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
PERMIT EXTENDED ILJAQmD be in place prior to approval to. fill pool/spa & shall remain in place & be maintained for the
PERMIT FINAL ' ASBESTOSNOTIFICATION 15 NOT APPLICABLE TO life of the pool.
CERTIFICATE OF �f—aa-23�-1L�/`'lit— PROPOSED DEMOLITION
OCCUPANCY 155UEO SIGNATURE: