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Home My WebLink AboutE2021-0760 - Permitsw,ft; City of w` Fr 100 Civic ( t Permit Cot c3 G�iIGyYiIYNyY Job Address: 2419 Description of Work: Inspector Area: 3 Legal Description: Owner: VANDERHOOKF Address: 2419 SANTIAGO NEWPORT BEA( Phone: Issued Date:11/04/2021 wport Beach - Building Division .r Drive, Newport Beach, CA 92660 Phone(949)644-3288 DR Bldq: 1 Floor: Suite: HEIGHTS LOT 287 11111111111111111�1111111111111�111111111111111111111 Electrical Permit: E2021-0760 Project No : 1053-2021 =L Contractor: -t ALIM Addr to 0 SARENA 92 IRVI I.E CA 926'12 M- Phone: 4-235 8644t Con State Lic 919876 Lic Expire 02112812022 r sx Inspection Requests Phone (949)644-3255 Code Edit: 2019 it applicable'. �t ..(( D/o reWnd gg ❑ $Oo/gt/` rkQ C*bhi()ensation Insurarl Carrier: LIBERTY MUTUAL Policy No: XW t0 VVhOTT)E 2/21/2021 Bus Lls BT30067678 - Processed By: Exp Date 11/30/2022 �w �� "` IT FEES New Construction acle/Switch/Outlets Motors/Transformer HP '\, . Residential Receptacles/Outlets: 2 $3.50 0 to 1 HPW/KVA b tl d Temp Undergroun 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 , 0 1 to 10 HP�iKW/KVA. Ff! $0.0: arted) Sub Panel: 0 $0.00 1-2 Family: 0 $0.004Vo ir �f� l$9� 10 to 50 HP/KW/KVAt n�wQCO�� f 0 $0.00 a �Ji 0 �6 00 50 to 100 HP/KW/KVA. 0 $0.00 '' ` 0 $0.00 service g arted) Over 100 HP/KW/KVA: 0 $0.00 e$0.00 0-600V up to 20OA: 0 $0.00 h CIr NNOI $0,00 Plan $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Pig B ower: 0 0.0 r i-t�92a1 gatioif"Fee. .y. s $0.00 P. Over 600V or 1000A: 0 $0.00 Time Clocks: 0 'amp Power Pole: 0 Its, s=Fe'"' $38.00 O/H to U/G 0 $0.00 ��'�jon $0.00'�' Supplemental Fee: $0.00 TOTAL Fee $41.50 Fee Due at Permit Issuance : $41.50 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.mo$gd Splurday from 8:00 a.m. to 6:00 p.m. fNER-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) ction 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' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Besiness and fessions 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 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, liness 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). L-1 I, as owner of the propert am exclusive apply to an owner of prope y w o ul s or Improves thereo pand who contracts for the projects with a licensed Contractor pursuant to the Contractors' State ❑ I am exempt from licen re u er the Contractors' Stat icel3e•La' r the followin reason: By my signature below I ac nowl etwexceot for my o on r d h' h 1 g 1 h s'a d for at completion of the imps sell a structure that I have ilt as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applica Professions Code, is avails le upon request when this lication is subrLllttedf at tJ�gf,Qllow{tig.aALebe:http:// vv ,, MFn G7�Ip,A� Signature of Property Own orA Agent - I —I �'JO��r-r �VU% refund LICENSED CONTRACT R' ECLARATION" I hereby affirm under penal of p jury that I am licensed under provisions of Chapter 9 (commencing with Se_tti GIN slon 3 of the Business and Pr and effect. . _ �� .,i d�1 License Class - License No �(\�!`�''- Date `;-� J (iV V Contractor Signatur WORKERS' COMPENS TII ATION NARNING: FAILURE TO SECURE OR Vne PENS I01 COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE H COST OF COMPENSATION, DAMA ESAEDFOR IN SFCTON 3706 OF THE LASER CODE INTEREST AND ATTORNEYS FEESi hereby affirm under penalt of p of the following declarations._ I have and will maintai �a certficate or consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided riTance of the work for hlch this permit is issued. Policy No. wave and will maintain orker compensation insurance, as r$$e��gyyuiryq[ed by@Section 3700 of bor e, for the performanc of the ork for which is f ce carrier and policy umb v ' JA I Imltk[,� 1 n Li i ca ra Ept an Jame of Agent `n1n CC prr "sSpp' �` one # �I certify that, in the perfor ante of th work f r�4Rfd h3 27Fn f1s sued, 1 shall not employ any person In any manner sD as to bet me subject to the we sat, if I should become subj t to the w rkers' compe ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applican )ECLARATION REG CONSTIRCTION NDING AGE hereby affirm under pen f perjury tha Is a constructionWinding agency for the performance of the work for whjglrstpljs f4�f11 iahs (S ' .ender's Name Address ly my signature below, cart 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 1 1 agree to comply with all applicable city and county ordinances nd state ws relating to building construction. I authorize representatives of this city or county enter the ab ve-ide i d prop for inspection purposes. >ignature of Property Owner or Authorized Agent P roperty Owner's or Authorized Agent's Name State License Law does not Law). Section 7044 of the Business and Code, arV my license is in full force DOLLARS j$100,9Do1.Jl ADDITION TO THE Section 3700 of the Labor Code, for nit is issued. My workers' compensation laws of California, and ACTION BY DECLARATION OF COMPLIANCE LNITH CODE OF FOR OFFICE USE ONLY 'rZD �,_?iL REG'JLAT/CNSPt.PT6f-CIFTITLE40AND .SOMC RULE '40 3. PERMIT EXPIRED -] 1 iUBidf7 fEJ ASBES TOS NO7R7CATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED rDATE PERMIT EXTENDED ❑ ASBESTOS NOTIFICA77ON IS NOT APPLICABLE TO PRDPOSED DEldOLIT,ON. PERMIT FINAL CERTIFICATE OF SIGNPTUPE: OCCUPANCYISSUED