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Home My WebLink AboutE2023-0687 - Permits� *,Po", City of Newport Beach p`r 6 a ;� Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 = Permit Counter Phone: (949) 718-1888 Cq��p0.N�P newportbeachca.gov/civic Electrical Permit Plan Check No : PC2022-2014 Work Class : Other Issued Date : 08/02/2023 Final Date: Permit Status: Issued Inspection Area : 3 E2023-0687 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NOLATERTHAN 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: 1945 SANTIAGO DR Legal Desc : N TR 4710 BLK LOT 5 Description : ELEC INSTALL ELECTRICAL LINE FOR EXT BBQ ISLAND (XR2022-2176) Owner: KLOENNE FAMILY TRUST Address : 1100 VIA VERDE SAN DIMAS, CA 91773 Phone: Applicant: DEWALDBEZUIDENHOUT Address: 87 VERMILLION IRVINE, CA 92603 Phone: (949)649-9447 Owner/Builder: KLOENNE FAMILY TRUST Address: 1100 VIA VERDE SAN DIMAS, CA 91773 Phone : Contractor Address Phone: Con State Lie Lie Expire Bus Lie : Bus Lie Expire: Workers' Compensation Insurance Carrier : Policy No: W. C. Expire: Code Edition : Fire Hazard Zone : NO Type of Construction : Occupancy Groups : U Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone : X Use Zone: R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: SPECIAL CONDITIONS: I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placednext to the applicable item(s) 'action 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 va permit to file a signed statement thathe 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 rofesslons Code) or that he or she is exempt from licensors 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 ZOi ore than five hundred dollars (lil I as owner of the property, or my employees with wages as their sole compensation,will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, ustness art 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 nprovements 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 nproved 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 �yply to an owner of property who builds or improves thereon, and Who contracts for the projects witha licensed Contractor pursuant to the Contractors' State License Law), J f am exempt from licensure under the Contractors' Stale License Law for the following reason: y 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 legail, ell 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 'rofesslons Code, is available upon request when this application Is submitted or at the following Web site:http:ltw .leginfo.ca.govlca.law.html. ignature of Property Owner or Authoriznd Agent Date ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70D0) of Division 3 of the Business and Professions Code, and my license is in full forge rid effect. License Class License No Date Contractor Signature WORKERS` COMPENSATION DECLARATION WARNING: 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 (SIBS ), IN ADDITION TO THE C057 OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 th performance of the work for which this permit is issued. Policy No. ❑I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for theperformance of the work for Which this permit is Issued. My workers' Compensatio insurance carrier and policy number are Canter Policy Number Expiration Date ND a of Agent Phone N 1 certify that, in the porter of e 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 ha , If I should becorna a ject ie orkers' compensation. provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant ...._ _ Date, DECLARATION REGARDIN O' STR�TION LENDING AGENCY I hereby affirm under penalty of pe"ury that on lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lendar s Name Lender's Address By my signature below, I certify to each of the foll4havepr I am the properly owner or authorized to act on is behalf. I have read this application and the informatiois correctI rgree to comply with all applicable city and ca d state laws relating to building construction. IPuthoriz= wrxesentalives of this city or counve identified property for inspection purposes. 1 i f} SI Pature of Propet Owner or Authorized Agent Print PropertyOwner's or Authorized Agent's Name O t I C ACT'ON j DATE BY DE ON OP CO NCE NTTH CODE OF FEDERAL FOR OFFICE USE ONLY . RFGUTIONS PART 61 OFTITCE 40 AND AQMD RULE 1403 PERMIT EXPIREC I SUBMITTED ASBESTOS NOTIFICATION TO PER�CAAICE. r:.LD DEPA. PFFMIT EXTENOE'J LIAQMD i'ERNIi fIIJAI ❑ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF U�N%l PROP05EDOEMOUTION j OCCI PANCYf"SUEO D r SIGNATURE: