HomeMy WebLinkAboutE2023-0349 - PermitsCity of Newport Beach
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Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
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newportbeachca.gov/inspections
1111111111111111�1 ll1111lill1111111111111111jj Electrical Permit : E2023-0349
Plan Check No :
Work Class : Other
> ! Issued Date : 04/1812023
Inspection Area : 7
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: 600 NEWPORT CENTER DR, 150 Legal Desc : P BK 295 PG 33 PAR 3
Description : COMM ELEC INSTALL 3 OUTLETS
Owner: 610 NEWPORT CENTER DR LLC
Address : 610 NEWPORT CENTER DR STE890 NEWPORT BEACH, CA 92660
Phone : (949) 720-2400
Applicant: Joseph Mendoza
Address : 5022 Van Buren St. Yorba Linda, CA 92886
Phone: (714) 262-0703
Owner/Builder
Address
Phone:
Code Edition : 2022
Type of Construction :
Contractor : DYNAMIC ELECTRICAL SOLUTIONS CO
Address :
16835 ALGONQUIN ST, STE 164 HUNTINGTON BEACH, CA 92649
Phone :
(714) 907-3325
Con State Lie:
978307
Lie Expire :
01/31/2025
Bus Lie:
BT30073547
Bus Lie Expire:11/30/2023
Workers' Compensation
Insurance
Carrier:
PREFERRED EMPLOYERS INSURANCE COMPANY
Policy No :
WKN1534179
W. C. Expire:
4/8/2024
Fire Hazard Zone : NO
Occupancy Groups : B
Building Setbacks :
Flood Zone :
X
Use Zone :
PC - North Newport Center
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PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby erfirm 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)
cfion 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
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
fessions Code) or that he or she is exempt from licensufe 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
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,
tress 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
rovements 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
roved 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
Iy 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).
J I am exempt from licensure under the Contractors' State License Law for the following reason: _
3y 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 legall.
all 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
Irofessions Code, is available upon request when this application Is submitted or at the following Web site:http:lt r .leginfo.ca.gov/calaw.iltml.
319nawre of Property Owner or Authorized Agent Dale
-ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 f lvisidjin 3 Of the Business and Prof sin Cale, and my license is in full force
Ind effect. License Class License No Date Contractor Signature
NORKERS' COMPENSATION DECLARATION
YARNING; FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED USAND DOLLARS ($100,0001, IN ADDITION TO THE
IOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
-11 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
)errormance of the work for which this permit is issued. Policy No.
have and will maintain workers' compensation insurance,as required by Section 3700 of the Labor Code, for the performance of the workfor which this permit is Issued. My workers' compensaliol
s rance carrier and policy number are:
;arlar Policy Number Expiration Date
dame of Agent Phone N
:1I certify that, in the performance If he work for which this permit is issued, f shall not employ any parson in any manner so as to become subject to the workers' compensation laws of California, and ogre
hat, if i should become subject to kern' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
3lgnature of Applicant
)ECLARATION REGARDING O RUCTION LENDING AGENCY
hereby affirm under penalty o pe jury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
.enders Name Lenders Address
3y my signature below, I certify to each of the following:
I am the pruperty owner or authorized to act on the property owner's behalf.
I have read this application and the Information l have provideciis correct.
I agree to comply with all applicable city and county ordhanceA and state laws relating to building construction.
Iauthorize. representatives of this city or county to e r lh -identified property for inspection purposes. l�.�/ p
ii „ t.ture of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's Nameffi4Date / �O
ACTION DATE f BY DEC RAN OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
1, RF6 L IONS PART 61 OF TITLE 40 AND AQMD RULE.
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