HomeMy WebLinkAboutE2021-0800 - Permitsywtr,�t City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
,y. Permit Counter Phone (949)644-3288
Job Address: 1701 NEWPORT HILLS DR W Bldg: 1 Floor: Suite:
Description of Work: ELEC TO BBQ, FIREPIT, FIREPLACE (S2021-0260)
Inspector Area: 4
Legal Description: N TR 7032 LOT 1
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Electrical Permit: E2021-0800
Project No : 2730-2021
Owner: ANDERSEN JASON
Contractor:
INSTANT POOLSCAPES
Address: 1701 W NEWPORT HILLS DR
Address:
833 DOVER DR #24
NEWPORT BEACH CA 92660
NEWPORT BEACH CA 92663
Phone:
Phone:
949-795.0648
Con State Lic:
1009644
Issued Date:11/22/2021
Lic Expire:
12/31/2021
Bus Lic:
BT30053469
Processed By:
Lic Exp Date:
12/31/2021
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: WC EXEMPT
Policy No: (NO EMPLOYEES)
Expire :
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New Construction
Receptacle/Switch/Outlets
Motors/Transformers(HP/KVA)
`°mmcm
°mamm
Residential
Receptacles/Outlets:
3
$5.25
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
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 Back[Temp 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:
$38.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL Fee:
$43.25
Plan Check Fee : $0.00
Fee Due at Permit Issuance:
$43.25
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.
OWNER -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
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 for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do `) all of or L) 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).
❑ I 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:http://www.leginfo.ca.gov/calaw.htm].
Signature of Property Owner or Authorized Agent Date
LICENSED dIdlITUCTOR'S DECLARATION
Z bvr*f; affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a rofessions�e IS, and my license is in full force
'and effEct. ""'"
Dr ns eClass License No Date �I_._ _ _. O Contractor Signature
WORKERS' C®MPANSATION DECLARATION
IWAF N.Irf �i FAILURE JQ SEQrRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE
0 •W COMPENSTION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
WerRhy affirm yridei penalty of perjury one of the following declarations:
®N•h9ve and wilj 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
xmence of the work for which this permit is issued. Policy No.
hav; and v1i:Oairyiain workers' compensation insurance, as required by Section 3700 of the Labor Code,
r9Arie carrier jand pplicy number are:
IV •"" ; Policy Number
le of Agent, " ----------
for the performance of the work for which this permit is issued. My workers'
Date
if
that, in the performs a of the work for wh ' ' ed, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
I should become subje he work n I provisions f Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date ��� - Z.-Z - -L
CLARATION REG D N6CONST N LENDI NCY
areby affirm under pe Ity of perju at ther onstruction 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. S L �-i
have read this application and the information I have a is corr t.
I agree to comply with all applicable city and cou ordinances and st a Its ruction. _
I authorize representatives of this city or county o t€r the ab ntified prope inspection purposes. 27-7
nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam(e_2 Date /
ACTLON
DATE
BY
DECLARATION OF COMPLIANCE MTR CODE OF
'. FOR OFFICE USE ONLY
FEDERAL REGULATIOIVSPART 61 OF TITLE 40ANO
AQMD RULE 4403.
PERMIT EXPIRED
❑ I SUDMITTEDASBESTOS NOTIFICATION TO:.
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS NOURCARONIS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
PERMITFLNAt
2� /y/fi
CERTFFICATEOF
OCCUPANCYISSUEO
SIGNATURE:.