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Home My WebLink AboutE2019-0238 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 ��IYiIMT'� Job Address: 25 HERMITAGE LN Bldg: 1 Floor: Suite: Description of Work: ELEC/SERVICE UPGRADE TO 400 AMP Inspector Area: 4 Legal Description: TR NO 7223 LOT 80 POR OF LOT AND POR OF LOT 81 Owner: ZEHENNI ANTHONY Contractor: OWNER/BLDR Address: 25 HERMITAGE LN Address: NEjNF0R rB€ACH, CA 92660 Phone: A49-287-3861 Issued 0 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 over20OA: 1 $88.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL 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 'E2019-0238` Electrical Permit: E2019-0238 Project No : Inspection Requests Phone (949)644-3255 a Code Edit: 2016 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 Check Fee: Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 e at Permit Issuance : $123.00 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. DECLARATION I hereby affirm under penalty 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) (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 issuance, also requires the applicant for the 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 Divielul1 3 of the Business and Professions 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 permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 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, 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 or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or im Ed 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 apply to an owner er.1roperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt f-cr 'icensure under the Contractors' State License L w for the following reason: ey n;-i3nature below I acknowledge that, except for my person idpnce in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner -builder if it ha been cob, strutted in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the usine s and Professions Code, is available upon request wh th' plication is s itte r at the following Web site:http://www.leginfo.ca.gov/calaw.html. Eigna;LTe of Property Owner or Authorized Agent Date Z152 LICEVSED CONTRACTOR'S DECLARATIO I hereby affirm under penalty of perjury that I am4ieeil under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. `� License Class License No Date Contractor Signatur4,d NORKERS' COMPENSATION DECLARATION ,WARNING. FAILURE '.O 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby, affirm under penalty of perjury one of the following declarations: J I have and W lei :T.aintain 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 the 3erformance 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' compensatior nsurance carrier and policy number are: ier Policy Number Expiration Date Va of Agent Phone# Ify that, in the performan e w k for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' laws of California, and agree If I should become su ' to the wo ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. compensation Signature of Applicant Date �� C Z,Z /� DECLARATION RERDIYSTRUCYION teNUMG AG NCY hereby affirm under ty of perjury that there is a cons ction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -ender's Name Lender's Address 3y my signature below, I certify to each of the following: I 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 or ' es d state laws relating to building construction. / I authorize representatives of this city or county t Mier the ab id ntified property for inspection purposes. %(�� Signature of Property Owner or Authorized Age _ Print Property Owner's or Authorized Ageent's. Nam >`WT14c�Ji �+.+ Dater �, Z jc ACTION DALE BY DECLARATION OF COMPLIANCE MTH CODE OF FEDERAL REGULATIONS PANT Of OFTITLE40AND AQMD RULE 1403. ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIRCATIONIS NOTAPPLICABL.E TO PROPOSED DEMOLITION. SIGNATURE: FOR OFFICE USE ONLY PERMIT EXPI RED PERMITCANCELLED PERMITEXTENDED PERMIT FINAL 60 CERTIFICATE OF OCCUPANCYISSUEO