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Home My WebLink AboutE2022-0093 - PermitsCity of Newport Beach - Building Division d 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �+tixai%�j9h Job Address: 1459 GALAXY DR Bldg: 1 Floor: Description of Work: ELEC-TEMP POWER POLE Inspector Area: 3 Legal Description: N TR 4224 LOT 257 Owner: VON DER AHE DANIELLE & GEOFF Contractor: Address: 1459 GALAXY DR Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:02/15/2022 Lic Expire: Bus Lic: Date: Processed By: Lic Exp E 2 0 2 2 0 0 9 3�� II MILO CONSTRUCTION 101 VIA MONTE PICAYO SAN CLEMENTE CA 92673 949-290-6429 871429 03/31/2022 BT30038762 03/31/2022 Electrical Permit: E2022-0093 Project No : 2349-2021 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Workers Compensation Insurance Carrier: NO EMPLOYEES Policy No: Expire : New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA)0.00 Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: $0,00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 Service - Signs Over 100 HP/KW/KVA: 0 ,5 *g0. 0.00 a ` 1 Plan Check Fee: $ 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 v 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy BackfTemp Power: 0 $0. n anon Fee: 38.00 .00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $41.00 Supp eal Fee: $$0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Fee: $79.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $79.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 P.M. 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 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 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 Business and Professions Code: The Contractors' State License Law does not apply to an owner L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, improvements are not intended or offered for sale. If, however, the building or improvement is solof property who, through employees' or personal effort, builds or improves the property, provided that the improved for the purpose of sale). d within one year of completion, the Owner -Builder will have the burden of proving that it was not built or ❑ 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 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). ❑ 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 in which I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legall. 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 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://www.leginfo.ca.gov/calaw.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 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 S• 2102-2— Contractor SignatureD� �-c-2 NORKERS' COMPENSATION DECLARATION YARNING: 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 :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 1 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 thi lerformance of the work for which this permit is issued. Policy No. :1I 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' compensatior isurance carrier and policy number are: Policy Number of Agent Date Ir 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 agre it, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. InatureofApplicant �( d/.� i _� �'-�F_ Date��.. YJ Zo2,t— :CLARATION REGARDING CONSTRUCTION LENDING A NCY ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (SecLtion 3097, Civil Code). rider'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 owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -!den ified pro arty for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam �G GD DatecD•!S. ZoZ. ACRON DATE BY DECLARATIONOFCOMPUANCEIMTHCOL)EOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND PERMIT EXPI RED AQe4D RULE 1403. PERMIT CANCELLED , 0 'SUBMITTEDASBEST7S NOTIFICATION TO: C] EPA PERMITEX7ENDED ❑ AG'MD' PERNf1T FINAL /j0 ❑ ASBESTOS N0r7ACAT'0Nr3 tXTAPPLICABLE TO r ,^• �i2. p/L- e PROPOSED DEMOLITION. OCCUPANCYISSUED I I II SIGNAI UkE: