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Home My WebLink AboutE2020-0494 - PermitsCity A Newport Beach - Building Division llp11111111111111111111111111111111111111111111 Jill 4 100 Civ c Center Drive, Newport Beach, CA 92660 F a„ Permit Counter Phone (949)644-3288 4 i Job Address: 158 WOODBURNE Bldg: 1 Floor: Suite: Description of Work: ELI=C A/C DISCONNECT Inspector Area: 4 Legal Description: TR 11604 LOT 2 UNIT 92 OF PROJECT LOCATED ON AP 442-291-40 TOGETHER Owner: HEGENEROE Address: 158 WOODB JRNE NEWPORT E EACH, CA 92660 Phone: Issued Date:09/15/2020 Processed By: 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 over20OA: 0 $0.00 Over600V orI000A: 0 $0.00 O/H to U/G 0 $0.00 TOTALPee: Contractor: GREENSTAR HOME SERVICES Address: 965 RIDGE LAKE BLVD #201 MEMPHIS TN 38120 Phone: 949-885-0102 Con State Lie: 795556 Lie Expire: 02/28/2022 Bus Lie: BT30056111 Lie Exp Date: 08/31/2021 Receptacle/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 Plan Electrical Permit: E2020-0494 Project No Inspection Requests Phone (949)644-3255 II\ SPE Code Edit: 2019 Worker's Compensation Insurance Carrier: LIBERTY INS Policy No: WA76313508631019 Expire : 10/0112020 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 C,rQR ^a Temp Underground: 0 Sub Panel: 1 0 0 Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Due at Permit Issuance : $65 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. $0.00 $28.00 $0.00 $0.00 $0.00 $0.00 $0.00 $37.00 $0.00 I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forthe reason(s) indicated below by the checkmark(s) 1 have placed next to the apf.!icable 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, pdorto its issuance, also require: the applicant for permit to Me 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 c f the Business and fessions Code) or that oe 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 0 a civil penalty of more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do U allof or U portions of the work, and the structure is not intended or offered for sale (5 action 7044, ;Ines 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 moved 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 Licen.;a Law does not Ity to an mr..a: 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 exe:i.p,,rom licensure under the Contractors' State License law for the following reason: .ny signature below I a::knowledge that, except for my personal residence In which I must how nmiided for at least one year prior to completion of the improvements covered by this pr r it, I cannot legal a structure Oat, 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 fessions Code, is available upon request when this application is submitted or at the following Web site:httpa/www.leginfo.ca.govlcalaw.html. rature of Plooerty Owr er or Authorized Anent .ICENSED --Ol rOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencingYCFUMINAL io 7000) Division 3 of the Business : -. effect k=.use ClaLs _._ _ License No Dat�� Contractor Signature ZL YORKERS' COMPENSATION DECLARATION IPPN'NG: FAILURE TO SECURI_WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUWECT AN EMPIA PENALTIES AND CIVIL FINES UP TO ONE OST IF COMPENSAmON, DAL;AGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm u, leer pene ny of perjury one of the following declarations: and my lice ose.isJn-full force tSrDO,D -0), IN ADDITION TO THE J I i,ave and will m rite in 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 Cade, for thi go ornuance of :i,e work her which this permit is issued. Policy No. knave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My w• rkars' compensatior nce Carrier and policy number are: Wrier Policy Number Expiration Date lame of Agent Phone # 3I certify that, in the perf.rrm ce of a coo for which this permit is issued, I shall not employ any person in any manner so as to become subject to t e workers' compensation laws o California, and agre' rat, if I should become scbj to worke ',,c, won provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pre 'si signature of Applicant � ' Date "lf, 6J xJ IECLAR4T10N RI AR ON ION LENDING AGENCY hereby affirm under p4l of pegury that there is a construction lending agency for the performance of the work for which this permit is issued (e n 3097, Civil Code). enders Name Lender's Address ly my signature below, I certify to each of the following: I am the property owns or authorized to act on the prop owner's behalf. I have read this application and the information I har�, Itaove-Eelfie Isct. I agree to comply with all applicable city an counonnde laws relating to building construction, \ I`/I,) I authorize representatives of this city or cool the erty for inspection purposes. / d LXn U(� y I J nor AC770M DATE / \ ay ❑ ISVBWTTEDAS13ESTOSNO7IFfOIIIONTO; ❑ EPA ❑ AOMD ❑ ASBESTOS NO77RCATIONIS NOT APPLICABLE TO PROPOSED DEMOL1770M ••••_„' I I _� SIGNATURE, OCCUFANCYISSUED