HomeMy WebLinkAboutE2020-0398 - Permits�xwiv,T City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIII�IIII'IIIIIIIIIII II
41 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 3 9 8
Permit Counter Phone (949)644-3288
+ty uud'
Job Address: 23 HARBOR ISLAND Bldg: 1 Floor: Suite:
Description of Work: ELEC -TEMP POWER POLE (X2020-1784)
Inspector Area: 2
Legal Description: TR 802 LOT 23 ALL -INC BET SAME & HIGH TIDE LINE -
Owner: PICKUP TODD
Address: 23 HARBOR ISLAND
NEWPORT BEACH, CA 92660
Phone:
Issued Date:08/07/2020
Processed
New Construction
Residential
Multi -Family:
1-2 Family:
N
Service
0-600V up to 20OA: 0
0-600V over 20OA: 0
Over 600V or 1000A: 0
O/H to U/G 0
Contractor:
DYER J C COMPANY INC
Address:
1540 S COAST HWY #205
LAGUNA BEACH CA 92651
Phone:
714-809-3258
Con State Lic:
586784
Lic Expire:
03/3112022
Bus Lic:
BT98042174
Lic Exp Date: 02/2812021
Receptacle/Switch/Outlets
Receptacles/Outlets:
0
$0.00
$0.00
Fixtures:
0
$0.00
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Signs
$0.00
Branch Circuit:
0
$0.00
$0.00
Each Add Circuit:
0
$0.00
$0.00
Time Clocks:
0
$0.00
$0.00
Additional Fee :
$0.00
Electrical Permit: E2020-0398
Project No : 2708-2019
Inspection Requests Phone (943)644-3255
Code Edit: 2019
Workers Compensation Insurance
Carrier: EVERST NATIONAL
Policy No: 7600012640201
Expire : 01/0112021
NO CONSTRUCTION NOISE
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 $39.00
Temp Underground:
Sub Panel:
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
11 TOTAL Fee: $74.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $74.00 I 11
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 Df perjury that lam exempt from the ContractorsState License Law for the reasons) indicated below by me checkmark(s) I nave placed next to the applicable nettle)
(Section 7031.5, Business and Professions Code: Any city orcounty that requires a parmato Construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
me permit to tale a signed statement that no or she IS licensed pursuant to the provisions of the ConlraCMrs' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Proless'fons Coda) or that he or she is exempt from liconsure and tha basis for the alleged Exemption. Arty violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civit penalty, of
not moi a than live hundred dollars (WOW.
131, as owner of the property, or my employees with wages as their sole Compensation, will do U all of or IL) portions of the work. and the structure is not intended or Offered for sale (Section 7044.
Busim:ss and Professions Coda: 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-Builderwill have the burden of proving that it was not built or
IR
m ED for the purpose of sale).
, es owner of tyre property, am exclusively contracting with licensed Contractors to construct the project (Section 7044. Business and Professions Cade: The Contractors' State License Law does not
y eo 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).
am exempt from Itcensure, under file Contractors' State License Law for the following reason:
By my signature below t acknowledge that. except for my personal residence in which I must have reskled for at least one year prior to completion of the Improvements covered by this permit I cannot legally
sell a ntnlcture that I nave built as an owner -builder if It has hot been constructed in Its entirety by licensed contractor's. I understand that a Copy of the applicable law. Section 7044 of the Business and
Profas sions Code, is available upon request when this application Is submitted or at the following Web site:httpyrwww.leginto.ca.gavrcalaw.Mml.
Sigrmijie of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hems y affirm under penalty of Do ry,,hat I am licensed under provisions of Chapter 0 (C$mmencing with SEctic 7000) of D ision 3 of me Business and ProfessiongrCode, a license is in full force
and 2ileCt. LICEn5E CIa55 ._b LiCanSfl No 5+�`p7gF}' Da do2� Contractor Slgnatuix ��
WOR.<ERS' COMPENSATION DECLARATION
WARNIK:: FAILURETO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTESAND CNIL FINES UP TO ONE HUNDRED THOUSAND DOIJARS (610A000), IN ADDITION TO THE
COST U: GOMPENSATIO 14GESAS PROVIDED FOR INSECTION3706 OFTHE LABOR CODE INTEREST, ANDATTORNETS FEES
I heresy affirm of perjury one of the following declarations:
tfy{51 mtain a cennicate 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
pedor work for Which this permit is ISSURV. Poncy No.
nave and will maintain workers' compensation insurance, as required by Section 2700 of me Labor Code, for the performance of the work for which this permit Is Issued. My workers' Compensate
Insure ce canter and policy number are:
Cadde; 1C I�r(.A'Ilfr iI`UVr"CG PoncyNumbar 7te000,.2&4c)�2p1 ExpiratwnDate OIJOIL�2/
Name Df Agent Phone 4
f agility That, In the performance of the work for which this pamtft is issued. I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, mist agrat
met, it I should become subject to tile workers' compensation provisions of Se con 3700 of tite Labor Code. 1 shall forthwith comply with those provisions.
Sigmatae of Appilcan?V i--0(f{T 0"GC /1 ,2/7N/1 Da i� /JA 07/epd3U
DECL,RATION REGARDING CONSTRU ON LENDING AGENCY I
l hares ;r affirm Under panarty Of perjury that thane is a construction lending agency for the performance of the work for which this permit is issued (Section 3007, Civil Code).
Lendar's Name Lender's Address
By my signature below, I Certify to each of the following:
Ian me property owner or authorized to am on tine properly owner's behalf,
I hive read this application and the Information I have provided is correct.
1 a Tree to comply with all applicable city and county ordinances and state taws relating to building construction.
I authorize representatives Dt this city on coo t. enter the above-Iderni Jed prop for inspection purposes. }(
Sl nature of PropertyOmer or Aumonzetl ent C C Pnnt Property Owners or Authorized Agem's Mortis' 0/!6� DaYVJ O
ACrIO.J DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART' 61 OF TITLE 40 AND AOAM1D RULE
1403
PEhW: r EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO
PERA4rr CANCELLED UEPA
PERM; r EXTENDED OMO
P£RPW"FINAL ASBESTOS NOTtACATIGN IS NCT APPUCA,pLE TO
CERrIFIC47EOF 'S I -At Dti•L PROPOSED DEMOLITION -2
OCCUP,4111CYISSUED SIGNATURE: