HomeMy WebLinkAboutE2022-0840 - PermitsCity of Newport Beach IIII I I II I II I II III I II II II Electrical Permit : E2022-0840
Community Development Department- Building Division
y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
U $ Permit Counter Phone: (949) 644-3288 Work Class : Other
a.< Inspection Requests Phone: (949) 644-3255 Issued Date :
ogcr�c ac�`P newportbeachca.gov/inspections 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 : 204 PEARL AVE
Description: ELEC - OH TO UG
Owner: SHELLEY STARR
Address : 204 PEARL AVE NEWPORT BEACH, CA 92662
Phone:
Applicant: Mark Dupuy
Address : 5827 Pearce Ave lakewood, CA 90712
Phone : (562) 577-4645
Owner/Builder :
Address
Phone :
Code Edition : 2019
Type of Construction :
Legal Desc : A TR BALBOA ISLAND RESUB SEC 1 BLK 8 LOT 26
Contractor : Mark Dupuy
Address : 5827 Pearce Ave lakewood, CA 90712
Phone: (562)677-4645
Con State Lie : 1035848
Lie Expire : 02/29/2024
Bus Lie : BT30079780
Bus Lie Expire:09/30/2023
Workers' Compensation Insurance .
Carrier : STATE COMPENSATION INSURANCE FUND
Policy No: 9080612
W. C. Expire: 9/1 /2023
Fire Hazard Zone : NO
Occupancy Groups:
Building Setbacks : Front: 6, Side: 3, Side: 3, Rear: 5
Flood Zone : X; AO 1
Use Zone : R-BI - Two -Unit Residential, Balboa Island
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury, that I am exempt from the Contractors' State License Law for the reason(*) indicate
(Section 7031:5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demoll
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Lai.
Professions Code) or that he or she is exempt from licensors and the basis for the alleged exemption. Any violation of Section
not rare than five hundred dollars ($500)..
0 I, as owner of the property,or my employees with wages as their sole compensation. will do (_) all of or (_) portions of the
Business and Professions Cade The Contractors' State License Low does not apply to an owner of property who, through am
improvements are not intended or offered for sale. lL however, the building or Improvement is sold within one year of compiet
improved for the purpose of sale).
0 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, BL
epp€y to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pt
I am exempt from licensure under the Contractors' State License Law for the fallowing reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at feast one yea
soli a structure that I have built as an owner -builder if it has not been constructed In its entirety by licensed contractors. I undo
Professions Code, isovail9ble upon request when this application is submitted or at the following Web sfte:htlj:c lwWw.leginfo ,
Signature of Proper,y Cjwi mr- or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby a'n" unacr pa,>;.Ity of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 �zaf 4
and affect. License Class License No _.. Date,i f
Rs' COMPENSATION DECLARATION
7AILURE TI SECURI, WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALI
.CMPENSATIUi,, J, MAOES AS PROVIDED FORM SECTION 37M OF THE LABOR CODE. INTEREST, AND ATTORNEY'$ FEES.
affirm under pz,,61ty of perjury one of the following declarations:
,., and will maintain a certificate of consent to self -insure for workerscompensation, issued by the Director of
,ice of the Work for which this permit is issued. Policy No..
i ,no wilt mai• tali workers' compensation insurance. as required by Section 3700 of the Labor Code, for the pa
i+ amier and policy number are:
Policy Number
Is of Agent
certify that, In the performance
if I should become subject ly
of Applicant
below by the cheekmark(s) I have placed next to the applicable fterri(s)
or repair any structure, poor to its issuance, also requires the applicant for
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
)31:5 by any applicant fora permit subjects the Applicant to a civil penalty of
k, and the structure is notintended or offered for sale (Section 7044,
ees' or personal effort, builds or improves the property, provided that the
the Owner -Builder will have the burden of proving that It was not built or
and Professions Code: The Contractors• State License Law does not
to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Suction 7044 of the Business and
IM
3 pf the Business and Profess a de my license is in full force
Contractor Signature.
AND CIVIL FINES UP TO ONE HUNDRED TH66SAKD DOLLARS 41 SRBODI. IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is Issued. My workers'
Date
for which J,rpprovH
ermit is issued, 1. Shell not employ any person in any manner so s to become subject to the workers' oompensation laws of California, and agre
comport sions of Section 3700 of the Labor Cnde 1 shall forthwith c ply with those provisrans. Data
hereby affirm under penalty of�erjury that there is a construction lending agency for the performance of the Work for which
enders Name Lender's Address
ly my signature below, f certify to each of the following:
I am the property owner or authorized to act an 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 or noes and state fa lating to building construction
I authorize representatives of this city or county to a er thap'N�ove-ldenti property for inspection purposes.
permit is issued (Section 3097, Civil Code).
to,u DJr v
ACTION DATE ( BY - --__-- ABA OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE Ut ONLY
GULATiONS PART fit OF TITLE AO AND ADMIT RULE
1403
PERMITEXPIRED E UISUBMITTED ASBESTOS NOTIFICATION TO.
PERMIT
remmll "NAL / 1;4ASHESTOSN (CATION IS NOT APPLICABLE TO
CERrIFfCArE OF PROPOSED DE" OLI IO
OCCUPANCYISSUED 1 SIGNATURE: I -
1, 7.7