HomeMy WebLinkAboutE2023-0484 - PermitsaEw'aoRT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : E2U23-0484
4 Community Development Department -Building Division E 2 0 2 3 0 4 8 4
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
6 � I Permit Counter Phone: (949) 718-1888 Issued Date : 06/01I2023
,. newportbeachca.gov/civic Inspection Area :1�
°q<rr'oa"�P Combination Type -
."'�� Work Class - Simple
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 : 3226 CLAY ST Legal Desc :
Description: ELEC CHANGE OUT MAIN PANEL AND 3 SUB PANELS
Owner: ERIKA SIMS
Address : 3226 CLAY ST
NEWPORT BEACH, CA 92663
Phone
Applicant: BAYNE ELECTRICAL COMPANY
Address : 20 VERCELLI
IRVINE, CA 92620
Phone : (949) 300-7450
Owner/Builder :
Address :
Phone
Code Edition :
Type of Construction ;
Occupancy Groups:
Bldg Height:
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY:
SPECIAL CONDITIONS:
Contractor: BAYNE ELECTRICAL COMPANY
Architect
Address : 20 VERCELLI
Address
IRVINE, CA 92620
- '-
Phone: (949)300-7450
Phone:
Con State Lic : 1068432
State Lic
Lic Expire : 06/30/2025
Bus Lic: BT30081742
Engineer:
Bus Lic Expire : 06/30/2024
Address
Workers' Compensation Insurance
Phone:
Carrier: BERKSHIRE HATHAWAY
Policy No: N9WC683092
Designer:
W. C. Expire : 10/6/2023
Address
Phone:
Fire Sprinklers : NO
Construction Valuation
Fire Hazard Zone : NO
Added/New/TI sq. ft. Bldg : 0
No of Units :
Alteration sq. ft. Bldg :
No of Stories :
Added/New sq. ft. Garage : 0
TOTAL sq. ft. : 0
OWNER -BUILDER DECLARATION
I herebyaffirm 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 Items)
(Sec(lon 7031,5, Business and Professions Code: Any city or county that requires a permit to construct, altar, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
the permit to file a signedstatement 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
Professions Code) or that he or she is exempt from licensure, and the basis far 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 (E500),
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work; and the structure is not intended or offered for sale (Section 7044,
Business and Professions Gale: 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
improvements 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
ffi roved for the purpose of sale).
3�.7 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Gode: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contract=' State License Law).
I 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 ill which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legali
sell 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 copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site;httpl/www.ieginfo.ca.govtcslaw.hhni.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commencing With Section " sloh 3 of the Business and Pmfe ens Coda, an my license is in full force
and effect. License Class License No Date 277 Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HONOR THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
e3T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, MO ATTORNEY'$ FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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
edormance of the work for which this permit Is issued, Policy No.
have :and will maintain workers' Compensation insurance, as required by Section 370D of the Labor Code, for the performance of the work for which this permit is issued. My workers' compeneatiol
sushi, carrier and policy number are:
:artier Policy Number Expiration Date
tame of Agent Phone #
]I certify that, in th perf ..aria of the work for which this permit is issued: I shall not employ any person any manner so as to become subject to the wX
' Dompensattort laws of California, and ogre
xat, if I should becom s fact to the workers' pensation provisions so Sao
3700 of the Labor Code, I shall forthwith comply With those provisions. �7
signature of Applican - O it 7
uECLARATION REG Q CO UCTIN LENDING AGENCYhereby affirm under ally paijury that there isa construction lending agency for the performance of the work for which this permit is 'Issued (Section 30vll Code),
enders Name Lenders Address
IV 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 nt ordinances and state laws relating to building Consruction.
I authorize representatives of this city or counto nttkr th veddentified propery for i Drposes.
ii nature of Pr an Owner ar Autnanzed A ant Pnnl Prp a Owners or Authorized Agent's Name
4CTION DATE. Ry { RATIONOF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
PERMIFCANCELLED
LiePP.
PERMIt Ex'tENDED
...._.__
A{t"nD ®_�� _
PERMIT FINAL 2
��L�7
ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF
.PROPOSED DEMOLITION
OCCUPANCY153UED
SIGNATURE-