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Home My WebLink AboutE2021-0198 - Permits9City of Newport Beach - Building Division 11IIII1IIIIIIIIIIIIIIIII1III1III1IIIIIIIIIIII111Electrical Permit: E2021-0198 ��' 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 1 9 8 Project No: 1231-2020 - Permit Counter Phone (949)644-3288 �'r irs u�"a No CONS RUCTION Ss Inspection Requests Phone(949)644-3255 9 R_t ®'49� Job Address: 400 40TH ST Bldg: 1 Floor: Suite: Description of Work: ELECrrEMP POWER POLE ON SAT y Inspector Area: 1 Code Edit: 2019 Legal Description: CANAL SECTION BILK 439 LOT 1 Owner: SNOW KEVIN/DEBBIE Contractor: CLAYTON BUILDERS INC Worker's Compensation Insurance Address: 27055 CALLE JUANITA Address: 393 LA PERLE PLACE Carrier, EXEMPT i CAPISTRANO BEACH CA 92624 COSTA MESA CA 92627 Policy No: NO EMPLOYEES Phone: Phone: 949-279-5910 Expire Con State Lic: 846631 Issued Date:03/16/2021 Lic Expire: 09/30/2022 Bus Lic BT30043010 Processed By: „�'� Lic Exp Date: 04/30/2021 FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 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 Backrremp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $41.00 Issuance Fee: $37.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 TOTAL Fee: $78.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $78.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday -Friday 7:00 a.m. to 6:30 Q m. and Saturday from 8:00 a.m. to 6:00 p.m. ° . ... .° ®e,a wee ,e a a ee° ea° DWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 U all of or U 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, 1 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.html. 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 Business an sions C,pde, and my license is in full force and effect. !/ /�/�i License Class License No Date Z Contractor Signatu^3 WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the fallowing declarations: 111 have 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 th, performance of the work for which this permit is issued. Policy No. ❑I have 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' compensatiol insurance carrier and policy number are: Policy Number of Agent Date JI certify that, in the performance of the rk for which his 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, rat, if I should become s ject to t/I7��J rk rs' rap s n prove Section 3700 of the Labor Code, I shall forthwith comply with those provisions. */& ignature of Applican //I �'� Date DECLARATION RENG CONSTRUCTION LENDING A CY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cade). enders Name Lender's Address y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. - ,-/�1///./J 1////)/,,�///�//q 1 agree to comply with all applicable city and county ordin ces and st to laws relating to building construction. c'C V vL (�" / (` E� I authorize representatives of this city or county fL eftj th a o = n ifred r inspection purposes. Jnnature of Prnnertv Owner or Authorized Acent �( , Print Property Owner's or Authorized Agent's Name D AC'71ON DATE BY DECLARATION OF COMPLIANCE W#TN CODE OF FOR OFIIICE USE ONLY FEBERAt7,GUL#1-VAWART jf'QF INLE40AND AQl4>�1 RU 940% ❑ jsU0M9#tDA!43€ArQSiYLt1iF1C1hbff TO: E1 EPA •• • •s• ❑ AQMD PERMITEXPIRED PERANTCANCELLED PERMITEXTENDED ❑ ASBESTOS NOT#RCAROMISNOTAPPLICABL€TO PROMEtYWW1JT1 M, •', ':` o. , a . e o , SIGAIgURE:' 0 0 0 o 0 0 0 PERMITFINAL C€R17FICATE OF OCCUPANCYISSU€D o 110 0 0 o c 0 0 0 0 0