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Home My WebLink AboutE2020-0421 - Permits�xrok City of Newport Beach -Building Division *E2020 0421* J{ '^ 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 y� C e�rx�rnti'�� Job Address: 260 CAGNEY LN Bldg: 1 Floor: 1 Suite, III Description of Work: MFR ELEC (1) RECESSED LIGHT IN BATHROOM (REV20.0988) OWNER/BLDR FORM ATTACHED Inspector Area: Legal Description: TR 8336 LOT 4 UNIT 218 OF PROJECT LOCATED ON AP 423-011-22 TOGETHER Owner: KIM DOING KYO Contractor: OWNERIBLDR Address: 260 CAGNEY LN #111 Address: KIM CLAIRE NEWPORT BEACH, CA 92663 Phone: 949-394-7584 Phone: 949-394-7584 Con State Lic: O/B Issued Date:O,RK.4J2020 Lic Expire: Bus Lic: Processed B . Lic Exp Date: New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 1 $115 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: $38.75 Plan Che Electrical Permit: E2020-0421 Project No : 0646-2020 Inspection Requests Phone (949)f 44-3255 INSRECTC Code Edit: 2019 Worker's Compensation Insurance Carrier; Policy No: Expire : FEES Motors/Transformers (HP/KVA) 0 to 1 HPIKW/KVA: 0 $0.00 1 to 10 HP/KWIKVA: 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 Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Fee Due at 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 6:00 a.m. to 6:00 p.m. $37 )WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) 1 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, priorto 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 )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 permitsubjects the apf Ifcant to a civil penalty of lot more than five hundred dollars ($500). J 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 Vale (Section 7044, 3usiness 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 prooerty, provided that the 031bvements 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 Was for the purpose of sale). W, 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 Ipply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Stale License Law). 1 am exempt from licensure under the Contractors' State License Law for the following reason: 3y my signature below 1 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 :his permit, I cannot legall; all 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, S ction 70" of the Business and )rofessions Code, is available upon req t when this p a0on jjss syybbrRilted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authon gent ,�n A%X%�'Clr' N ate 0812012020 -ICENSED CONTRACTOR'S DECRATION hereby affirm Murder 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 ray license is in full force and effect. .1cense Class License No Date Contractor Signature ':ORKERS' COMPENSATION DECLARATION 1ARNING_ 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 :DST OF COMFENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby afP m uTder penalty of perjury one of the following declarations: 7 I have ..r.d wid maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 �f the Labor Cade, for th erforma"r, �f Lhe work for which this permit is issued. Policy No. have cnd Ma 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' range carrier and policy number are: Policy Number of Agrr.`. Date :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 sub ct to the workers' compensation Isws of California, and agree t, if I shou'd tazo subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With thos visions. nature ofAppl nt a 08/20/2020 CLARATION ARDIN UCTION LENDING AGENCY ueby affirm under penalty of per)ury 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: 1 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 ordinances and state laws relating to building construction. I authorize representatives of this city �c�my t Tn�Y��rthe a/h5,ov Identified property for inspection purposes. 1I DDn k O Kim nature of Property Owner or Authorized Ag�Lit �A'ii�N ^� Print Property Owner's or Authorized ADenf�YlamegyLn8,12012020 ACTION DATE BY DECLAPA770NOFCGiWPLIANCEMTHCODEOF FEDERAL REGULATIONS PART fit OF TITLE 40AND AQMORULE1403. ❑ iStIBMNTEDASBESTOSNOTiFtcATfONTOr ❑ EPA ❑ AQMD ❑ ASBESTOS IV071FICA710NIS NOTAPPLtCABLE TO PROPOSED DEMOLITION. SIGNATURE: FOROF17CE1131=ONLY PERMITE7fPIRED PERMIT CANCELLED PERMIT EXTENDED PERMITFINAL - �zl Ft-- CER77FICATEOF OCCUPANCY/SSUED