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Home My WebLink AboutE2022-0048 - Permits'xwrot. City of Newport Beach - Building Division "E2022-0048` 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 f r L�L1Yn1ANl�•. � ti 'L.. 6 � 'Jf' [ Job Address: 20282 RIVERSIDE DR Bldg: 1 Floor: Suite: Description of Work: SFR ELEC - 100A TEMPORARY POWER POLE [X2021-2560] FRIENDS OF NB ANIMAL SHELTER Inspector Area: 3 Legal Description: Owner: FRIENDS OF NEWPORT BEACH ANIMAL SHELTER Contractor: Compensation Insurance Address: PO BOX 10791 Address: 5500 E LA PALMA AVE NEWPORT BEACH, CA 92658 ANAHEIM CA 92807 Phone: 949-718-3454 Phone: 714-765-7551 Con State Lic: 980589 Issued Date:01/25/2022 Lic Expire: 01/31/2023 Bus Lic: BT30029399 Processed By: �� Lic Exp Date: 09/30/2022 New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over 20OA: 0 $0.00 Over 600V or 1o00A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee : $79.00 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Electrical Permit: E2022-0048 Project No : 2219-2021 Inspection Requests Phone (949)644-3255 Code Edit: 2019 POWER PLUS - Workur's Carrier: FEDERAL INSURANCE COIV.F'ANY Policy No: 54309652 Expire : 0313112022 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: 1 $41.00 Plan Check Fee : Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record MgmtFee: $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(s) 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, prier 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 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). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, iusiness 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). 7 I, as owner ,if the p.operty, 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 3n 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). J I am exempt Srura Ii::ensure under the Contractors' State License Law for the following reason: i). my Signature below I 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) ell a structure that 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. 6vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Igr.atur3 of Property Cmner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm L,nde,, Penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section l7!'0�0�0)- of DDiiviissi/onn 33 of the Business and es ions Code, a y li nse is in full force JL e�iact. y ��' dJ' cpe Z i icaaa„ Class � 0 p License Nog ( Date / � ratter Signature ✓ORKERS' COMPENSATION DECLARATION AANING: 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 05T nF COMPENSATION, D4MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 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, for th erjbrmance of the work for which this permit is issued. Policy No. 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' rance carrier and policy number are: ieofAgent :2 fL T-VOrt certify that, in the performance of the work for if I should become subiert Are workers' 0 of Applicant Policy Number Date permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensaa of California, and 1 provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi S. Date � f1-� 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). ender's Name Lender's Address y 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 c nt ordinances stlaws relating to building construction. I authorize representatives of this city or coun t the ab, lifted property for inspection purposes. X �Dril ignature of Property Owner or Authorized Agent iC Print Property Owner's or Authorized Agent's Name ACT70N DATE BY DECLARATION OFCOMPUANCE MTHCOOE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMFTCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIFiCATEOF SIGNATURE: OCCUPANCYISSUEO KIWIN. Dv'()"Vt� Z j