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Home My WebLink AboutE2015-0683 - Permits(1) City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 12 OLD COURSE DR Bldg: 1 Floor: Suite: Description of Work: ELEC - LIGHTS & HEATERS AT (E) PATIO Inspector Area: 4 Legal Description: N TR 15388 LOT 43 Owner: MURPHY BRIAN Contractor: Address: 12 OLD COURSE DR Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:12/10/2015 Lic Expire: Bus Lic: Processed By: Lic Exp Date: URBAN LANDSCAPE MAINTENANCE INC 895 DOVE ST 3RD FLR NEWPORT BEACH CA 92660 949-637-8767 962251 06/30/2017 BT30042651 05131/2016 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 4 $4.00 Multi -Family: 0 $0.00 Fixtures: 6 $6.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 100oA: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Fee: $19.00 Electrical Permit: E2015-0683 Project No : 1264-2015 Inspection Requests Phone (949)644-3255 Code Edit:2013 3?' Worker's Compensation Insurance _ J I LA Carrier: REPUBLIC UNDERWRITER Policy No: ATWO03386 " Expire : 10/09/2016 FEES Motors/Transformers (HP/KVA) 0to1HP/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[Femp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee : PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $0.00 Supplemental Fee: $9.00 Fee Due at Permit Issuance: $19.00 )WNER-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) 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 1e 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 'rofessions Code) or that he or she is exempt from Iicensure 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). 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, '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 the property, 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). 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 pply to an owr E- D`. Fr3perty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I an, exemptfrom Iicensure under the Contractors' State License Law for the following reason: y my e'gnatur^ below-1 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) PII a Rtructure 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 'rcressans Code,'is available upon request when this application is submitted or at the following Web site:http://v w .leginfo.ca.gov/ralaw.html. ignature of Property Cwner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm urde, penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prof 'ona Code, and my lice s.iR full force no e5ect. q� iaLrsa Class License No D N2-_ �� X T Contractor SignatUfE v0kK,ERS' COMPENSATION DECLARATION LT Y ARNING: FAILURL IL aECORE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CET 0-- ^OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 tht rman a of the work for which this permit is issued. Policy No. 1 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' carrier and policy number are: Policy Number Date me of Agent rnone s certify that, in the erformance of 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 t, if I should beco subject the w mpensation rovof Section 3700 of the Labor Code, I shall forthwith comply with those provis S. ` ^� nature of Applican Date l L l CLARATION REGA RDINGgDNWRGC3KWL1END CY areby affirm under penalty of perjury tha a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider's Name Lender's Address 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 with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city, or cou n e -r for in purposes. 1' nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na tyl f k M / -vet )L ACTION DATE BY DECLARATION OF COMPLIANCE MTNCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OFTITLE40AND PERMIT EXPIRED AQMD RULE 1403. ❑ I SUBMITTEDASBESTOS NOTIFICATION TO: PERMIT CANCELLED ❑ EPA PERMITEXTENDED ❑ AQMD STOS NOTIFICATION IS NOT APPLICABLE TO PERMIT FINAL G - —/G PROPOSED DEMOLITION. CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED