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Home My WebLink AboutE2021-0394 - Permits0514,'_ City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 °ermit Counter Phone (949)644-3288 Job Address: 20171 BAY VIEW AVE Bldg: 1 Floor: Suite: Description of Work: ELEC/TEMP. POWER POLE Inspector Area: 3 Legal Description: N TR 1507 LOT 9 Owner: FARAH FARZIN & FARHAD Contractor: OWNER/BLDR Address: 3366 FUCHSIA ST Address: FARAH FARHAD COSTA MESA, CA 92626 Phone: Phone: Con State Lic: O/B Issued Date: 07101 /2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: 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 over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 Fee : 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 Plan IIIIIIIIIIIIIIIIIIIIIIIIIIIIII II II Electrical Permit: E2021-0394 Project No : 0085-2021 Inspection Requests Phone (949)644-3255 cc Code Edit: 2019 LA �l J Worker's Compensation Insurance z Carrier : Policy No: Expire : FEES Motors/Transformers (HPIKVA) 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 Backrremp Power: 0 $0.00 Temp Power Pole: 1 $41.00 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 e at Permit Issuance: $79.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday- Friday 7:00 a.m. to §:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. 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, prior to its issuance, also require' `� applicant for the 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 �t the Business and Professions 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 not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, RUaiiness 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 iaZpr ements 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 im ro ed for the purpose of sale). , 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 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 legally sell a structure that I have built as an owner -builder J 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 Professions Code, is available upon request wh6Q tylis application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATIPRII I hereby affirm under penalty of perjury that I am ficensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. 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 Industrial Relations as provided for by Section 3700 of the Labor Code, for )rmance 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' compensal rance carrier and policy number are: Policy Number of Agent Date I 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 agree t if I should become bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p�royvisjoPs 'signature of Applicant /'a1/2e3X IECLARATION REGfiPDMG CONSTFWCTION L DING AGENCY hereby affirm under p nalty 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 county prdinances and state laws relating to building construction. I authorize representatives of this city or coun to yfiter the above -identified property for inspection purposes. � ignature of Property Owner or Authorized Agent P` _ 1 -./ /.._� Print Property Owner's or Authorized Agent's Nam\ P48)4AJ> )C }+kA)4 s7/B U2CZI ACTION DATE - BY DECLARATION OF COMPLIANCE IMTH CODE OF i i-,)ERAI. REGULATIGNS PART 81 OF TITLE 40 AND _ AQMC RLILE 1403. C1 ItiUHMITT=DA58ESTOSNOnFICATION'TO: ❑ EPA ❑ AQMD.. ❑ ASBESTOS N071ACA77ON IS NOT APPLICABLE TO PROPOSE& DEMl UPON. �;WNAI LIRE: FOR OFFICE USE ONLY PERMIT EXPRED _— PERMIT CANCELLED PERMfT EXTENDED PERMIT FINAL -'Ll CERTIFICATE OF OCCI)PANCYISSUED