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Home My WebLink AboutE2021-0390 - PermitsCity of Newport Beach - Building Division dp 100 Civic Center Drive, Newport Beach, CA 92660 r. Permit Counter Phone (949)644-3288 LJ T �'acryaix!' Job Address: 500 FULLERTON AVE Bldg: 1 Floor: Suite: Description of Work: ELEC -TEMP POWER POLE (X2021-1687) Inspector Area: 3 Legal Description: FIRST ADD TO NEWPORT HEIGHTS BILK 38 LOT 24 Owner: DOJA PROPERTIES LLC Contractor: OWNER/BLDR Address: 5050 W MISSION RD Address: ONTARIO CA 91762 Phone: 626-340-5461 Phone: Con State Lic: O/B Issued Date:06129/2021 Lic Expire: Bus Lic: Processed By: _ 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 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 IIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2021-0390 E 2 0 2 1 0 3 9 0 Project No : 1474-2021 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 Back/Temp Power: 0 $0.00 Temp Power Pole: 1 $41.00 Plan Check Fee : INEz,F`L`--_ u 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: $37.00 Supplemental Fee: $0.00 Fee Due 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. 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 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 L) 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' 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 Improved for the purpose of sale). I, 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 ap NY 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). m exempt from licensure under the Contractors' State License Law for the following reason: By m 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 Ves sell structure that I have built as an owner -builder if it has n t b an onstruc d i its entirety by licensed contractors. I understand that a copy of the applicable law, Section 70 o the Biness and sions Code, is available upon request whe i app c do is bmitte 0r t the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorizetl Agent 1 Da e u, LICENSED CONTRACTOR'S DECLARATI0 I hereby affirm under penalty of perjury that I am licensed rider 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 Contractor Signature COMPENSATION DECLARATION EARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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: 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 the 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 Expiration Date Agent Lill certi that, in the performance of th w rk r 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 that, if I hould become subject I th r rs' ompen Ion provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. '7 Signat a of Applicant rp f �� Da E RATION REGA I G CONSVFWCT16N LENDING AGENCY v'y� I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 rdi ces id state I s relating to building construction. I authorize representatives of this city or i toe e h b-identif property for inspection purposes. Signature of Property Owner or Authorized Agent rint Property Owner's or Authorized Agent's Name \ J. + "L�" i Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 1403. PERMITEXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED - PERMITEXTENDED ❑ ASBESTOS M077FICA77ON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL a' I- y_-t CERTIFVCA TE CF SIGNATURE: OCCUPANCYISSUED