The URL can be used to link to this page

Home My WebLink AboutE2021-0564 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 715 GOLDENROD AVE Bldg: 1 Floor: Description of Work: ELEC A/C DISCONNECT Inspector Area: 6 Legal Description: CORONA DEL MAR BLK 733 LOT 15 Owner: CUSHMAN ELIZABETH Contractor: Address: 1325 PACIFIC HWY #3402 Address: SAN DIEJO CA 92101 Phone: Phone: Con State Lic: Issued Date:09108/2021 Lic Expire: Bus Lic: Processed By:- :�O Lic Exp Date: 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 TOTAL Fee : $67.00 *E2021 -0564* Electrical Permit: E2021-0564 Project No : 1047-2021 HHCM CORPORATION PO BOX 12784 NEWPORT BEACH CA 92658 949-812-6300 978935 11/30/2022 BT30073531 11/30/2021 Rece pta c I e/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 Additional Fee : $0.00 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance ' Carrier: EXEMPT Policy No: NO EMPLOYEES ' 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 Piggy Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Temp Underground: 0 $0.00 Sub Panel: 1 $29.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : 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 p.m. vrY'I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law far the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) ff (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). 1, 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 cf 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 „ur.i :icensure under the Contractors' State License Law for the following reason: E� n; 3'gnature heiow I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the impro ements covered by this permit, I cannot legally sell a structure tnat 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 applica leection 0 of the Business and Piofes�lons Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. SignLt.:re of Property Owner or Authorized Agent0711r,L;CENSED COJTRA.CTOR'SDECLARATION1 herrhy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Sectio 700 ) of Division 3 of the Business/Iny li rise is in full force and effect. License Class License No Date Contractor naturWORKERS' COMPENSATION DECLARATION�'AhNINGFAILURE .O SLCJRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL ES UP TOO E HU RS ($10 ,000), IN ADDITION TO THE COST OF COMPENSATION, iAMAGES 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: 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 performance of the work for which this permit is issued. Policy No. I have 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' compensatioi insurance carrier and policy number jare: Policy Number ame of Agent (///I certify that, in the perform"tce,Rlif I should becom ubj ignature of Applica ECLARATIO G N C I LEND hereby affirm e y ury that re is a cc Ender's Name y my signature below, I certify the following: I am the property owner or autho—nzMkQzcJ on the I have read this application and the information I ha, I agree to comply with all applicable city and county I authorize representatives of this city or cou e ignature of Property Owner or Authorized Agent NG Date Phone # t is any person in any manner so as to become subject to the worker corn (a sat laws of California, and ogre isions of Section 3700 of the Labor Code, I shall forthwith comply with those pi Dat G CY lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Address 3 to building cc tructiol fori Ion purposes. Print Name BY DECL RA7ION' FCOMPLIANCE WITNCODEOF FORD ICE USE ONLY ACTION DATE FED LREGULARONS PART 51 OF TITLE 40 AND AQM ULE 1403. ❑ 1 UBMITTEDASBESTOS NOTIFICATIONTO: EPA [I AQMD PERA?IT EXPIRED PERMIT CANCELLED - PERMIT EXTENDED �(_� ASBESTOS NOTIRCA71ONISNOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMIT FINAL '`��-� ;; ( CE,RTIRCATEOF OCCUPANCYISSUED /��