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Home My WebLink AboutE2021-0773 -�e+v,tA City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 'r Permit Counter Phone (949)644-3288 F r: Job Address: 411 EL MODENA AVE Bldg: 1 Floor: Suite: Description of Work: ELEC - TEMP POWER POLE (X2021-3066) Inspector Area: 3 Legal Description: FIRST ADD TO NEWPORT HEIGHTS ELK 26 LOT 22 Owner: GONZALEZ JOSE Contractor: OWNER/BLDR Address: 411 ELMODENAAVE Address: GONZALEZJOE NEWPORT BEACH, CA 92663 Phone: 949.975-0123 Phone: 661-644-7048 Con State Lic: O/B Issued Date:11/10/2021 Lic Expire: Bus Lic: Processed By: �t 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 over 20OA: 0 $0.00 Over 600V or 1000A: 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 111111111111111111111111111111111111111111111111111111 Electrical Permit: E2021-0773 E 2 0 2 1 0 7 7 3 Project No : 0703-2021 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier : Policy No: Expire : 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 Backr emp 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 Mgmt Fee: $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: Kopday,.- Friddy 7:00 a.m_ to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. LDER 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, prior to its issuance, also requires the applicant for 1e 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). 1 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, ;usiness 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). 1, 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 pply 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). 7 1 am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 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 available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html, lignature of Property Owner or Authorized Agent _Date_ .ICENSED CONTRACTOR'S DECLARATION - - -- - hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ofessio od my license is in. full force nd effect. .icense Class License No Date �l O 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 H DRED THO SAND DOLLARS 1$100,0001, IN ADOMON TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37D6 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( erformance 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: Policy Number Date e of Agent Phone # rtify that, in the performance of the work this-pe g is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agref t, I should become subject er pen tion pro ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date )iZ/,4/0/2./ CLARATION REGAR ONST CT DING AGENCY areby affirm under penalty of perju that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address 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 ordiranee�ryd-sta tatirtg`t0 building construction. I authorize representatives of this city or county t e e aGe,identifie • pert's./r inspection purposes. nature of Prooertv Owner or Authorized.ADent i Print Property Owner's or Authorized ADent's Name /1� .�X� OH G7 Date 11 /o z e ACTION DATE I I BY PERMITEXTENDED I I I PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED FEDERAL REC-IiLA7-'0NSPAtT, 61 DFTITLE40A,l& AQMD RULE 1-:03. ❑/SUSMI'7�DCfBESTCSN0'1IFIr"AF104 -O- ❑ EPA ❑ AQMD ❑ ASBESTOS N077HCATION /S NOT APPLICABLE TO PROPOSED DEMO•j TION. SIGNATURE:•. FOR OFFICE USE ONLY