HomeMy WebLinkAboutE2019-0454 - Permitss City of Newport Beach - Building Division
at 100 Civic Center Drive, Newport Beach, CA 92660
3 Permit Counter Phone (949)644-3288
r'�4rre�LL�`�
Electrical
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII o II Prect No 0741-2017 41 it : E2019-0454
Inspection Requests Phone (949)644-3255
Job Address: 2024 NAUTILUS LN Bldg: 1 Floor: Suite:
Description of Work: ELEC FOR BBQ+�
rti
I
Inspector Area: 3 Code Edit. 2016 t�3�
Legal Description: N TR 3763 LOT 75 " F
Owner.
Address:
HOLIDAY ADAM & JULIE Contractor: OWNER/BLDR
2024 NAUTILUS Address: HOLIDAYADAM
NEWPORT BEACH, CA 92660
Phone:
Phone:
Con State Lic: O/B
Issued Date:07/02/2019
Lic Expire:
S
Bus Lic:
Processed By: °✓
V/� '� Lic Exp Date:
Worker's Compensation Insurance
Carrier :
° ° ° °
Policy No:
.Expire:
New Construction
Receptacle/Switch/Outlets
os
0 0
Residential
Receptacles/Outlets:
1
00 0
O to 1 HP/KW/KVA:
coot
$0.00
Temp Underground:
= � 4
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA
0
$0.00
Sub Panel
c o o
ecoo�
1-2 Family:
0 0o
a
Sep Circuits:
0
cc000
PERMITS EXPIRE 980 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.
FEES
New Construction
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
1
$1.00
O to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
= � 4
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA
0
$0.00
Sub Panel
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
0
$0.00
Low Voltage
0
$0.00
50 to 100 HP/KW/KVA
0
$0.00
0
$0.00
Service
Signs
Over 100 HP/KW/KVA
0
$0.00
Record Mgmt Fee:
$0.00
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy Backrremp Power:
0
$0.00
Investigation Fee:
$0.00
Over 600V or,1000A:
0
$0.00
Time Clocks: '
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$35.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL Fee:
$36.00
Plan Check Fee: $0.00
Fee Due at Permit Issuance
: $36.00
PERMITS EXPIRE 980 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.
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
is 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 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
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 all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
kroved for the purpose of sale).
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
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 follow' reason:
ly my signature below I acknowledge that, except for my personal resident 'n whit m esided for at least one year prior to completion of the improvements covered this permit, I cannot legalll
ell a structure that I have built as an owner builder if it has not been r ted ntirety b tensed contractors. I understand that a copy of the applicable law, Section 44 ofahe B (sines and
'rofessions Code, is available upon request when tIs application is e g Web site:http://www.leginfo.ca.gov/calaw.htmi. n
signature of Property Owner or Authorized Agent Dat (/
.ICENSED CONTRACTOR'S DECLARATI
hereby affirm undei penalty of perjury that I am tensed under pro sions of Chap (commencing with Section 7000) of Division 3 of the Business and Professions ode, and my license is in full force
rd SEEM. ....
••
5edh%;O '.lass • • • • License No Date Contractor Signature
MARKERS' COMPENSATION DECLARATION
�ARTQ49�FAILURE T&SECURE 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
OST OF COMPENSP4T"pDAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hesebyaffirm lindarpenalty of perjury one of the following declarations:
I stave and yAll Tt9 tain 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
erformance of the -work for which this permit is issued. Policy No.
and will rilaintain 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'
carriej%q e4licy number are:
• Policy Number Expiration Date
Ia pfAgent •'
certify that, in the
pe ormance of the wecoe)nsatin
this
if I should become ubject to the work
lature of Aoolicant
reby affirm under�enalty of perjury that there is a constrW,
Ider's Name
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property
I have read this application and the information I have JP�rovil
I agree to comply with all applicable city and co ty o/{iintf
I authorize representatives of this city or county o e t r e
Owner or Authorized
ACTION I DATE
PERMfTCANCELLED
PERNTIT EXTENDED
OCCUPANCYISSUED
Ed, I shall not employ any person in any manner so as to become subject to a workers' compensation laws of California, and agre
[Section 3700 of the Labor Code, I shall forthwith comply with those provis' ns.
Dat
agency for the performance of the work for which this permit is issued (Section 3097, Civil Cod ).
Lender's Address _
laws relating to building construction.
:d property for inspection purposes.
Print Prooertv Owner's or
By
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PROPOSED DEMOLITION.
SIGNATURE: