HomeMy WebLinkAboutE2023-0620 - Permits¢�EWPoaT City of Newport Beach ' '
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
>b T Permit Counter Phone: (949) 718-1888
Cy�"o0.N�P newportheachca.gov/civic
Electrical Permit
Plan Check No : 1538.2022
Work Class : Other
Issued Date : 07/13/2023
Final Date:
Permit Status: Issued
Inspection Area : 6
E2023-0620
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 : 819 GARDENIA WAY Legal Dose : N TR 12245 BILK LOT 37
Description : ELEC *ADD'L SCOPE* INSTL 100 AMP SUB-PNL
Owner: REYNOLDS CRAIG L TR
Address : 819 GARDENIA WAY CORONA DEL MAR, CA 92625
Phone: (949)887-8820
Applicant : BURKHART BROTHER'S CONSTR INC
Address : 12 BALBOA COVES NEWPORT BEACH, CA 92663
Phone: (949)508-8478
Owner/Builder:
Address
Phone:
Code Edition : 2022
Type of Construction :
Building Setbacks : Front: 5, Side: 4, Rear: 10
Flood Zone : X
Use Zone : PC - Jasmine Park
PROCESSED BY: 1,
SPECIAL CONDITIONS: REV2023-1316
Contractor : BURKHART BROTHER'S CONSTR INC
Address : 12 BALBOA COVES NEWPORT BEACH, CA 92663
Phone: (949)508-8478 "
Can State Lie : 905510 - • • " ,
Lie Expire : 10131/2023 ;
Bus Lie: BT30026859 ,
Bus Lie Expire:03/31/2024
Workers' Compensation Insurance
Carrier : SECURITY NATIONAL INS CO
Policy No: SNP1426534 - -->>
W. C. Expire: 2/1/2024
Fire Hazard Zone : NO
Occupancy Groups
OWNER -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 items)
(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
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 of the Business and
Professions Code) or that he or she is exempt from licensors 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 (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' Stale 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
improved for the purpose of sale).
Ll I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The ContractorsState 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 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 legal
sell a structure that I have built as an owner -builder if it has not boon 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 when this application is submitted or at the following Web site:http:llwww.leginfo.ee.govlcalaw.html.
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 Se t)O) of DGprsion 3 of the 8 sp Ingss and Peofessi CGda, d y license is In full force
and effect. License Class License No � t 3 I �_ ConU/aa rr Signature
COMPENSATION DECLARATION
NARNING: FAILURIS Tn SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100.000), IN ADDITION TO THE
COST OF COMPCNSATIOr', DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE "Sea CODE, INTEREST. AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declaraflons:
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 IN
rylrfc-mance of the workfor which this permit is issued. Policy No,
and will ma'ntaln 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'
caner aou policy number are:
Pt of Agem
certify the(, in the perormanee of the
ir' shouldi�ecom7 sllbiXto the wo
atore of AppAigh
Policy Number
Date
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
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions._ ,
hereby affirm J.)dLr penalty of perjury that there is a construction lending ageneyfor the performance of the work for which this permit is issued (Section 3097, Civil Code).
enders Name Lender's Address
ly 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 countyyirdinances and state laws relating to building construction.
I authorize representatives of this city or county to liter the above -identified property for inspection purposes.
ACTION I DATE BY ( DECLARATION OF COMPLIANCE WITH CODE Or FEDERAL FOR OFF3CE USE ONLY
i REGULATIONS PART SI OF TITLE. 40 AND AQMD RUL€
NOTIFICATION TO
PERMITEMENOEO _ S (,�gQMD_J..v
PERMIT FINA[—„— —I ASBESTOS Of 15 NOT APPLICABLE TO
CERTIFICATEOF ^.ZD'�S D!'�� I PROPOSED DEMOLITION
OCCUPANCY ISSUED 1 SIGNATURE:
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