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Home My WebLink AboutE2021-0642 - Permits,�w•, ,� City of Newport Beach - Building Division �fR 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 U T Job Address: 313 FULLERTON AVE Bldg: 1 Floor: 1 Suite: B Description of Work: ELEC -ADD 2ND 200 AMP SERVICE FOR ADU (SEE E2019-0760 FOR FEES) Inspector Area: 3 Legal Description: FIRST ADD TO NEWPORT HEIGHTS BLK 18 LOT 17 Owner: HARDEN GUY Contractor: OWNER/BLDR Address: 313 FULLERTON AVE Address: HARDEN TERRY NEWPORT BEACH, CA 92663 Phone: Issued Date:09/28/2021 Processed 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 AL Fee: Phone: Con State Lic: O/B Lic Expire: Bus Lic: Lic Exp Date: 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 Electrical Permit: E2021-0642 Project No : 1608-2017 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: 0 $0.00 Plan Check Fee : Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Fee Due at Permit Issuance : 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. p $0.0 - 0 $0.0) IWNER-BUILDER DECLARATION I hereby affirm underpenalty of perjury that 1 am exempt from the Contractcrs' State License Law For the masons) Indicated below by the checkmark(s) 1 have placed neld to the applicable hems) 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 Lsuanca, also requlms the applicant is permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State Uoense Law (Chapter 0 (commencing with Sadler 7000) of Division 3 of the Business rotessions Code) or that he or she Is exempt from Iicensure and the basis for the alleged tra mpoon. Any violation of Section 7031.5 by any applicant for a peril subjects the epplimet to a Civil pal of more than five hundred dollars (3500). J 1, as owner of the property, or my employees with wages a , their sale compensation, will do U all of or fU portions of the work, and the structure Is not Intended or offered for sale (Section 7044, uslness and Professions Code: The Contractors' State License Lew does not apply to an owner of property who, through emplcyees' or personal effort, builds or improves the property, provided that th nprovemants are not intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the Owner -Budder will have the burden of proving that h was not built o Tproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contm&.ore to construct the project (Section 7044, Business and Professions Code; The Contmdtc rsl State License aw does no pply to an owner of property who builds or improves thereon, and whe contracts for the projects with a Icensed Contractor pursuant to the Contractors' Stale License Law). 7 I am exe.Tp: f am Iicensure under the Contractors' State License Lew for the following reason:_ y my signature bemw I acknowledge that, except for personal melds ea'I which I must have resided for at least one year prior to completion of the Improvements covered by this pernl8, I cannot It s" a structure that I have built as an owner -builder if h t b n con true d in Its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business r�fessions Cede. L available upon request when o its or at the following Web site:http:/fwwv.leglnto.ca.gov/calow.hml. IXA Ignature or oro�Pny Owner or Authorized Agent Dal �V ;CENSED CONTRACTOR'S DECIARATI hereby affirm under penalty of perjury that I am licensed and mvIsIQns of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license bl in full for. nd effect. loPnse Class _ License No Date Contractor Signature iORKERS' COMPENSATION DECLARATION 6MING: FAILUIU5'.O F ACRE WORKERS' COMPENSATION COVERAGE IS UNLAwFOL, AND all SUBJECT AN EMPLDPERTD CRIMINAL PENALTIES AID CIVIL PINES UP TO ONE HUNDRED THOUSAND COLLARS lStee,0007.IN ADOTON Tl D5. OF COMPill nJN, DAMAGES AS PROVIDED FOR IN SECTION 37DS OF THE LAaOR CODE, INTEREST, AND ATTORNEY'a FEES. isreby affirm rider penalty of perjury one of the following declarations: J I have and will .r.alntain a certificate of consent to self -Insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3703 of the Lahor Code, it, srformance of the twuk for which this permit is Issued. Policy No. JI hsve and rgll ma'ntain 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 worker' compent nuranoe car. iu a.): policy number are; Policy Number Date ame of Agent ' 11 ""— 2 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 Ca gornla, and at, If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Ignature of Applicant - Date _ ECIARATION REGARDING CONSTRUCTION LENDING AGENCY. Tereby efOrrn under penalty of perjury that there is a construction lending agency for the performance of the work for which this mmilt Is issued (Sectlor 3097. Civil Cade). ander's Name Lender's Address y my signature below, I certify to each of the following: I am the properly owner or authorized to act on the property owner's behalf, I have read this application and the city ndio� I heave provided I agree to comply with all applicable city end co no an eta a laws relating to building construction. I authorize representatives of this city or court o e d Ified property for Inspection purposes. /T� Date n , .«, to ,.cla nr Authndvad Anent's Name e ACTION DATE REGULATIONSPART 610FTITLE40AND AQMD RULE 1403. ❑ ISUBMITEDASBESTOSNOTIRCA77ONTO: ❑ EPA PERMITEXP/RED C4NCEllED ➢fRM17AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOUTION. MOTFEDERAL ➢fRM1 E)(MM D PERMIT FINAL SIGNATURE: CF471FICATEOF OCCUPAIVCYISSUEO _— A{ 24