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Home My WebLink AboutE2019-0727 - Permits4 IXk r City of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111111 0'1 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 7 2 7 Permit Counter Phone (949)644-3288 r�dA!'lY'�`tr Job Address: 26 HERMITAGE LN Bldg: 0 Floor: Suite: Description of Work: ELEC -6 RECEPTACLES (EXTERIOR) Inspector Area: 4 Legal Description: N TR 7223 LOT 109 Owner: YI CHIN Contractor: MICHAEL ROBERTS HOME BUILDER INC Address: 26 HERMITAGE LN Address: 6 CALLE ALIMAR NEWPORT BEACH CA 92660 RANCHO SANTA MARG CA 92688 Phone: 949-858-7540 Phone: 949-858-7540 Con State Lic: 681116 Issued Date: Lic Expire: 09/30/2021 Bus Lic: BT30060668 Processed By: Lic Exp Date: / 0"9//,3�0Z 2*0^p w-T®F' Electrical Permit: E2019-0727 Project No : 2220-2019 Inspection Requests Phone (949)644-3255 Code Edit: "Ba t�- Worker's Compensation Insurance Carrier: BENCHMARK INS CO Policy No: CST5015128 Expire : 0112412020 FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 6 $6.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to 200A: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back[Temp Power: 0 $0.00 Investigation Fee: Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 TOTAL Fee : $41.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $41.00 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 o,m. OWNER -BUILDER 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 Division 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 L) 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 improved 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 of property 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 from licensure under the Contractors' State 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 Iegall sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under 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 my license is in full force and effect. License Class License No Date — IA )nl7A4t Contractor Sig natur 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LASOR CODE, INTEREST, AND ATTORNEY's FEES. I 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 Relations as provided for by Section 3700 of the Labor Code, for th nnance of the work for which this permit is issued. Policy No. ve 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' compensatio insurance 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 that, if I should become subject to the workers' cpmmpens Lion r Isions of Section 3700 of the Labor Code, I shall forthwith comply with those provIisi/Drys Signature of Applicant �l9/l �./'N � DateX DECLARATION REGARDING CONSTRUCTION LENDING AGENCY ✓ `T� I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to a ter th a ve id ntified property for inspection purposes. ,� f t-h Q v-�! t u Signature of Property Owner or Authorized Age Print Property Owner's or Authorized Agent's Name Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PQRTfi1 OFTlTtE40AND ADMD RULE 1403. PERMIT EXPIRED ❑ t SUBMITTED ASBESTOS NOR€!CATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED _ � PERMITEXTENDED ❑ ASBESTOS NOTlRCATIONIS NOT APPLICABLE 70 PROPOSED DEMOLITION. PERMITFINAL CS' CERTIFICATEOF i SIGNATURE: DCC{1PANCYFSSU'ED