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Home My WebLink AboutE2015-0210 - Permitsa6wi,„4r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII II -� 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 5 0 2 1 0 F % Permit Counter Phone (949)644-3288 n c Job Address: 2706 VISTA DEL ORO Bldg: 1 Floor: Suite: Description of Work: ELEC/ PIGGY BACK Inspector Area: 3 Legal Description: N TR 7148 LOT 62 Owner: MAZY SANDRA Contractor: Address: 2706 VISTA DEL ORO Address: NEWPORT BEACH, CA 92660 Phone: Issued Date:04/07/2015 Processed 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 over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: GONZALES ANTHONY D 16356 VINTAGE WOODS LAKE FOREST CA 92630 949-257-8012 912170 03/31/2016 BT30049949 02/18/2016 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 Electrical Permit: E2015-0210 Project No: 0294-2015 Inspection Requests Phone (949)644-3255 Code Edit: 2013 Worker's Compensation Insurance Carrier: EXEMPT NO EMPLOYEES 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 Plan Check Piggy Backlfemp Power: 1 $35.00 Temp Power Pole: 0 $0.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Temp Underground: 0 $9.CC Sub Panel: C 0.00 0 MCC C $6.cc 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: $70.00 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 (_) 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 -Builder will have the burden of proving that it was not built or improved for the purpose of sale). 111, 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). ❑ I 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 legalh 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.html. 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 Prof sions Code, and my license is in full force and effect. License Class License No D 7 !'/.S� Contractor Signa INORKERS' COMPENSATION DECLARATION V'.FA" F:FAILURr. rn 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 JOST OF OOMPENSATKA, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I,ereLy affirm under penalty of perjury one of the following declarations: 1 have and wil' 7aintain 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 ierrtortnance of the. wnlK for which this permit is issued. Policy No. have and 011 rna:ntain 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' ranre carrier and policy number are: Agent y that, in the performance of Applicant Policy Number Expiration Date 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 kpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi s. ,J Date Ireby affirm under penalty of perjury k4fthere 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: 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 unty ordi nces an state laws relating to building construction. I authorize representatives of this city or cou o ant he ab e-identified�roperty for inspection purposes. nature of Property Owner or Authorized Age � -� Print PrODertv Owners or Authnrized Ananfk ACTION PERMITFINAL CERTIFICATEOF OCCUPANCYISSUED DATE I BY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 1403, ❑ 1 SUBMITTED ASBESTOS N077FICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS N077RCA77ON IS NOT APPLICABLE TO PROPOSED DEMOLITION. L ' I I SIGNATURE: f 710