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Home My WebLink AboutE2023-0689 - PermitsEWPORT City of Newport Beach O "ICommunity Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 cq� RN�r newportbeachca.gov/civic Electrical Permit Plan Check No : Work Class : Other Issued Date : 0810312023 Final Date: Permit Status: Issued Inspection Area : 4 E2023-0689 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 : 2040 VISTA CAJON Legal Desc : N TR 5480 BLK LOT 9 TR 5480 (L.L.84-214026) PAR 9 Description : ELEC PANEL UPGRADE 200 AMPS Owner: SUSAN HASBROUCK Address : 2040 VISTA CAJON NEWPORT BEACH, CA 92660 Phone: (208)284-9309 Applicant : GALLAGHER ELECTRIC Address : P O BOX 986 SAN CEMENTE, CA 92674 Phone: (949)370-7243 Owner/Builder Address Phone: Code Edition : 2022 Type of Construction Building Setbacks Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY SPECIAL CONDITIONS: Contractor : GALLAGHER ELECTRIC Address : P O BOX 986 SAN CEMENTE, CA 92674 Phone: (949)370-7243 Con State Lie : 903861 Lie Expire : 09/30/2023 Bus Lie : BT30082288 Bus Lie Expire: 08130/2024 Workers' Compensation Insurance Carrier : Policy No: EXEMPT W. C. Expire: Fire Hazard Zone : NO -� Occupancy Groups : U pj OWNER -BUILDER DECLARATION I hereby affirm under penally 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) Sectj m 7031.5, Business and Professions Code: Arty city or County that requires a permit to Construct, alter, Improve, demolish, or espaiI structure, prior to its Issuance, also requires the applicant for :he 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 ficensure and the basis for the alleged exemption, Any violation of Section 7031_5 by ariy applicant for a permit subjects the applicant to a civil penalty of Tot more than five hundred dollars (5500)., 1, as owner of the property,or my employees with wages as their sole compensation, will do (_) all of or U 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 orimprovement is sold within one yearof completion, the Owner -Builder will have the burden of proving that it was not built or . n iproved for the purpose of sale). I, as owner of The properly, am exclusively contracting with licensed Contractors to constructthe 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 pursuantto the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' Stale 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 legally scIt a structure that I have built asan owner-buildor 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:iM"e .leginfo.ca.govlcalaw.html. Signature of Property Owner or Authorized AgentDate LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7 ) of Division 3 of the Business and Profe ' n C eand lice. i in full force and effect License Class License No Dat Contractor Signature NORKERS' COMPENSATION DECLARATION PIARNING; FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNOR THOUSAND DOLLARS (E100,000), IN ADDITION TO THE COST OF COMPENSATION, OAMAAES As PROVIDED FOR IN SECTION 3706 Of THE LABOR CODE, INTEREST, AND ATTORNEY'S fSea. 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 RelaPions as provided for by Section 3700 of the Labor Coda, for in cerfornlance of the work for which this permit is issued. Policy No. _ ❑1 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' compensffiia risurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I 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 a f should be^cr'c •ubI of I&workers com ens^ to prov ions of Section 3700 of the Labor Code, I shall fortltwilh comply vrlltf.lhose provisions.DEC.LArrei Applicant Date _ _ ._ __m. _. _-6cGLAnATION $cGAR TION ENoI St ENCY hereby affirm under p_n Ity of perjury that there is a const client lending agency for the performance of the work for which this permit Is issued (Section 309 iW Cade). L^nr'ars Name _ _ Lenders Address By my signature betcw certify t each of the following[ I am The prappriy owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. agree to eo,np;y wi,in all applicable city and co my 7rd,moncois and state aws elating to building construction. :..Lthcrize representatives of this city or county t e ter bove-ida fi d o erty for inspection purposes. „ 7 2 S:c�1at�. L of Properrt�r Owner or Aulhodzed ;4 enl Print Property Owner's or Authorized Agent's Name/Jtate i ACTION DATE BY D. ARATION OF CO. PLIANCE WIT ODE OF FEDERAL FOR OFFICE USE ONLY _ - Rf:G UTA IONS PART bt. OF iITLF. 40AND AQMD RULE _ 1403 PERMIT EXPIRED El [SUBMITTED ASBESTOS NOTIFICATION TO FfRM1T CAACEtCEO EPA FERMITEXTENOED. .......... ........ ❑A ONTO ..._. _...... CERTIFICATE OF C�1 �J �O OSf.O DEMOLITION 15 NO APPLICABLE IO.. 1-212"l OCCUPANCY ISSUED SIGNATURE