HomeMy WebLinkAboutE2023-0370 - Permits�aEepRr City of Newport Beach
p Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
jjm1111111111111111111111111111111111111111111111111Electrical Permit : E2O23-0370
Plan Check No : PC2022-2622
Work Class : Other
Issued Date : 04/24/2023
Inspection Area : 4
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 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 : 5 CYPRESS POINT LN Legal Desc N TR 7223 BLK LOT 15
Description : ELEC 6 EXTERIOR OUTLETS
Owner: JAMES MARKHAM
Address : 5 CYPRESS POINT LN NEWPORT BEACH, CA 92660
Phone:
Applicant: MADISON J L CO
Address: 24682 DEL PRADO #230 DANA POINT, CA 92629
Phone: (949)212-6922
Owner/Builder :
Address
Phone :
Code Edition
Type of Construction
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY:
SPECIAL CONDITIONS:
Front: 10, Side: 5, Side: 5
X
PC - Big Canyon
Contractor : MADISON J L CO
Address :
24682 DEL PRADO #230 DANA POINT, CA 92629
Phone :
(949) 212-6922
Con State Lic
: 672668
Lic Expire :
06/30/2023
Bus Lic:
BT30080173
Bus Lic Expire:12/31/2023
Workers' Compensation
Insurance
Carrier :
OHIO SECURITY INSURANCE COMPANY
Policy No :
XWS60277669
W. C. Expire:
10/1/2023
Fire Hazard Zone : NO
Occupancy Groups :
OWNER -BUILDER
I hereby affirm under penally of perlrlry 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 items)
Section 7031.5, Business and Professions Cade: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, poor 10 9s issuance, else requires the applicant for
III 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
rofiessions Code) or that he or she is exempt from Ilcensure 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
of more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portlons of the work, and the structure is not Intended or offered for sale (Section 7044,
:usiness 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 theproperty, 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).
11, 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
poly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuantto the Contractors' State License Law).
1 am exempt from licensure under the Contractors' State License Law for the following reason.
Iy 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 Impro4coverec4this permit, I cannot legall)
all a structure that I have built as. an owner-buildar if it has not been constructed In its entirety by Ilconsed contractors. I understand that a copy of the applicabof the Business and
'rofiessions Code, is available upon request when this application Is submitted or at the following Web site:http:!lwww.leginfo.ca.govlcslaw.ntml.
Iignature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION
hereby affirm. under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ) f ivisi n 3 of the Business and Profy lieens ' In full force
nd effect. License Class L€tense No Date ,2O2ontractor Signature
VORKERS'COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREISIaD, IN ADOmON TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 17" OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
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 In
Lh
ance of the work for which this permit is issued. PolicyNo.
B and will maintain workers' compensation insurance, as required by Section 3700 of the Lobar Code, for the performance of the vrork for which this permit is issued. My workers" compensafrol
ce carrier and policy number are:
'arler Policy Number. Expiration Date
Name of Agent Phone
-II certify that in the PG101oman of khe wak f which this permit is issued. I shall oat employ any person in any Mannar so as to become subject ie the workers'compan atlon law of Callfomia, and ogre
That, it I should becomect t the works ampensahon provisions of Section 3700 of the Labor Code,. I shall forthwith comply with those provisions.Signature of Applicant DataZv...... _...DEiCLARATION REGG NST IDN NDING AGENCY
hereby affirm under penalty of perju. there is construction lending agency for the performance of the work for which this permit Is issued (Section 3097, NO Code).
_enders Name Lender's Address
3y my signature below, I certify to each of the following:
1 am the property owner or authorized reset on the pro dy owner's ehalf.
I have read this application and the information I have Havided is cor act.
I agree to comply withall applicable city and county or nances and lases relating to building construction.
I authorize representatives of this city or OUITV e r the above -id ified pro for inspection purposes. AA y
Signature of Property Owner or Authorized A ant p Print Property ate Owner's or Authorized Agent's Name rtRR P.10� xCZ
ACTION DATE BY LARA P OfN i NCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
RE LATI. PARTb p ITLE40ANDAOMD RULE
PERMIT EXPIRED LJ I SUBMITTED ASBESTO5 NOTIFICATION TO
PERMITCANCELLED E®EPA
PERMIT EXTENDED OM D
PERMi7 FINAL ASBES(DS NOTIFICATION 15 Nor APPLICABLE TO
CERflFXATEOF /z�/ PRO POSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE