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Home My WebLink AboutE2019-0345 - Permitsw City of Newport Beach - Building Division 7^ 100 Civic Center Drive, Newport Beach, CA 92660 rte, Permit Counter Phone (949)644-3288 Job Address: 1734 MIRAMAR DR Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE (X2019-1677) Inspector Area: 1 Legal Description: N TR 518 BLK K LOT 9 Owner: CEFALIA JIM Contractor: Address: PO BOX 551 Address: NEWPORT BEACH CA 92661 $0.00 Phone: 949-478-2593 Phone: Worker's Compensation Insurance Con State Lic: Issued Date:05/24/2019 Lic Expire: 0-600V over20OA: Bus Lic: Processed B\Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service . '— Worker's Compensation Insurance 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 II�IIIIIIIIIIIIIIIIIIIIIII�III�IIIIIIIIIIIIIIIIIII III Electrical l0 Permit: r it : E2019-0345 .8-2019 Inspection Requests Phone (949)644-3255 SHORELINE DEVELOPERS P O BOX 551 NEWPORT BEACH CA 92661 949-697-3993 890871 01/31/2021 BT30041079 10/31/2019 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. FEES Code Edit: 2016 . '— Worker's Compensation Insurance Receptacle/Switch/Outlets Carrier: STATE COMP Policy No: 9038773 Expire : 01/01/2020 0 $0.00 oomo 0 e Temp Underground: . e e 00 $pw, ° ti . a . .o e. . 0 00 a e' o 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. FEES . '— Receptacle/Switch/Outlets Motors/Transformers(HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $pw, ° ti Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel 6 $00.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $9-WO Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 = C $0.03,010 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: o o m® $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00. Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $38.00 Issuance Fee: $35.00 Additional Fee : $0.00 Supplemental Fee: $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $73.00 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. 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 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, 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, 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). ❑ 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 License Law does not apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.govlcalaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the i ss and Professions Code, and my license is in full force and effect. + License Class .... License No S 2 4 1 t i Contractor Si at e WORKERS' dOMAE'NSATION DECLARATION NAMM:FAILURa iO SSCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSAI%+DAMAGES AS PROVIDED FOR IN SECTION ]]05 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I•I11ajelly.affirm under penalty of perjury one of the following declarations: 0 I nave and vdll 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 the 44rIoi fiance oftt^,kor(t for which this permit is issued. Policy No. "Mi •e and wilf 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' compensatiol Insurance carrier aa8p9licy number are: Policy Number Date .m ame of Agent Phone # �6re0ify that, inpe performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subj ct to the workers' compensation laws of California, and agre 6nj,jf•IWre dome subject -t tlb or ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p ovisions. ; ean - 'e�;-' � I'�EGAR,PING y6CONSTRUCTION LENDING AGENCY hereby affirm under peWWty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address ymy 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 aVAorized(Agen y and county ordinances and state laws relating to building construction. I authorize representativesr county tolenter th bove-identified property for inspection purposes. ignature of Property Owner ot `-�" �� Print PropertyOwner's or Authorize 's Name ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODE OF FEDERAL REGULATIONS PART Of OF TIILE40AND PERMITEXPIR€D AQMD.RULE 1403. El I SUBMITTEDASBESTOS NOTIFICATION TO: PERMfTCANC€LLED ❑ EPA PERMITEXT€NDED ❑ AQMD ❑ ASBESTOS NORFICAIION/S NOT APPLICABLE TO PERA111"RNAL 511"'? 2 / C PROPOSEDDEMOLITION. SIGNATURE: ivy C -e? —(L4 ate !l -(1(5