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Home My WebLink AboutE2023-0610 - Permits�EWPogT City of Newport Beach 0� Community Development Department- Building Division n 100 Civic Center Drive, Newport Beach, CA 92650 Permit Counter Phone: (949) 718-1888 Cq��GO RN�P newportbeachca.gov/civic Electrical Permit Plan Check No : Work Class : Other Issued Date : 07/11/2023 Final Date: Permit Status: Issued Inspection Area :8 E2023-0610 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 : 1206 PEMBROKE LN Description : ELEC TEMP POWER POLE (X2021-0388) Owner: KALEM LLC Address : 2 GARDENIA IRVINE, CA 92620 Phone: (714)454-4305 Legal Desc : N TR 3607 BLK LOT 8 Applicant: AMPLE CONSTRUCTION Address: 5500 N CALLE SONORA YORBA LINDA, CA 92887 Phone: (714)454-4305 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction : Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: Contractor : AMPLE CONSTRUCTION Address : 5500 N CALLE SONORA YORBA LINDA, CA 9298? . Phone: (714)454-4305 " Con State Lic : 957060 Lic Expire : 01/31/2025 -.:. Bus Lic: BT30057810 .. Bus Lic Expire:06/30/2024 • - • - Workers' Compensation Insurance >>> Carrier: NORGUARD INSURANCE CO Policy No: HAWC334520 W. C. Expire: 11/1/2023 Fire Hazard Zone : NO Occupancy Groups: R3/U [hereby S'OUI under malt I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate license Law for the reasons) indicated below 6y the checkmark(s) I have placed nett to the applicable item ;action 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 a 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 Buslns, and rofessians 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 )t more than five hundred dollars ($500). 11, as owner of the property, or my employees with wages as their sole compensation. will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness and Professions Codes 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 'tprovements 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 npfoved for the purpose of sale). I, as owner of the properly, 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 pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: _._ _..._ .._.__--....___ _---.-------.---- ------ ----------- y 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 legally oil 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 'rofessians Code, is available upon request when this application is submitted or at the following Web site:http:llwww.leginio.ca.govlcalaw.html. Data signature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm and '1 penalty of peri'ury that I am licensed under provisions of Chapter 9 (commencing with Section 7QQ0�Q�) of D'€ 's�'i n 3 of tt,�e Business and Prof ss' ns C 8 and my license is In full force no effect. Lcens Cl, as License No Date lyQ4� pntraclor Signature v^f1r..E2S' CCMP_14ATION DECLARATION T IARNING. FAILURE TC SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS p DOLLARS 1S100,0001, IN ADDITION TO THE OS, OF LOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 070E OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. hareh7 affirm under penalty of perjury one of the following declarations: 1 rsin 1 have and Will maira certificate of consent to self -insure for workers' compensation, Issued by the Director of industrial Relations as provided for by Section 3700 of the Lobar Code, for Ih e4,f..nca of [he work for which this permit is issued. Policy No., ind will manta 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' carrier and policy number are: Date Policy Number area of Agent ' ..... �I certify that., in the pbrformane the 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 agre tat, if I should be �rnJ bject he workers compensation provisions of Section 3700 of the Labor Coda, I shall forthwith comply with those provisions. dgnatuce of Applicant. _,,,, Date��-F_�,_ IECLARATION REGA G NSTRI.ICTION LENDING AGENCY hereby affirm under pe ally of perjury that there Is a construction lending agency for the performance at the work for which this permit is issued (Section 3097, Civil Cade), order's Name Lenders Address. -- ly 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 withall applicable city and ccu I ordinances and slate laws relating to building construction. I authorize representatives of this city, or count t nter ih a ve-identified property for inspection purposes. ;ionature of Property Owner or Authorized Agent Print Property Owner's or Authorized A eri NamiziDat ACTION DATE BY E1fL4F SON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RFGULATIONS PART 51 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED 4 U I SUBMITTED ASBESTOS NOTIFICATION TO ELLED --------- ➢EAMIT CAACi EPA PERMIT£MENDE1. D AY- PfRMi7 FINAL ! /� � ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF aa PROPOSED DEMOLITION OCCUPANCYISSUEO �j ,{Y) SIGNATURE: