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E2018-0443 - Permits
tv City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 8 0 4 4 3 r Permit Counter Phone (949)644-3288 Job Address: 3622 BLUE KEY Bldg: 1 Floor: Suite: Description of Work: ELEC/ABOVE GROUND SPA (<5,000 GALLONS & W/APPROVED ASTM FI346-92 SAFTEY COVER) Inspector Area: Legal Description: N TR 6152 LOT 30 Owner: BYNDERALAN Contractor: Address: 3622 BLUE KY #DR Address: CORONA DEL MAR, CA 92625 $0.00 Phone: 949-689-3698 Phone: OWNER/BLDR Worker's Compensation Insurance Con State Lie: Issued Date:07/0312018 Lie Expire: Policy No: Bus Lie: Processed By: v Lie Exp Date: Electrical Permit: E2018-0443 . Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2016 0 $0.00 Receptacle/Switch/Outlets Residential $0.00 10 to 50 HP/KW/KVA: " OWNER/BLDR Worker's Compensation Insurance $0.00 BYNDER ALAN Carrier 0 Policy No: Fixtures: Expire $0.00 O/B 0 $0.00 Sep Circuits: New Construction 0 $0.00 Receptacle/Switch/Outlets Residential $0.00 10 to 50 HP/KW/KVA: Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 1 $6.00 $33.00 Supplemental Fee: Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: 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 Backfremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee: Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $33.00 Supplemental Fee: $0.00 e at Permit Issuance: $39.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday6 Friday 1:00 q.m. to q;30 pm. and Saturday from 8:00 a.m. to 6:00 p.m y a m m o o • o a e Gm c 4 e • 4 o e d 4 O 4 O p0 • p 4 G0¢ 6 4CG 4 wo u • oe• 4• c c c c o e c v i � c 4 00o eo 00 o c coo ao 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) lection 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 ie 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 Businbs 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). I, as owner of the properly, 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, ,usiness 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 nproved 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 pply 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: Iy 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 Iegall ell a structure that I have built as an owner -builder if it has not b an constru ed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Busin as and 'rofessions Code, is available upon request when (hjs applica(i su dor at th Ilowin Web site:http:!/www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent X / Date 3 .ICENSED CONTRACTOR'S DECLARATIO 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 and Professions Code, and my license is in full force nd effect icense Class License No Date Contractor Signature YORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 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 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 the erformance 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' compensatior Isurance carrier and policy number are: Policy Number Date lame of Agent """ I certify that, in the performanc of the work for which this 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 agree if I should become subject a wor s' cation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prows) ns7 signature of Applicant DateX ,/ IECLARATION REG RDIN CONSTR ION LENDING AGENCY �9 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 Code). Ender's Name Lender's Address Iy 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. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. 1015 �� I authorize representatives of this city or county to/ente above -Id 'fled property for inspection purposes. _ _ /y�a Iignature of Property Owner or Authorized Agent Y �� Print Property Owners or Authorized Agent's Nama�. /`'LGE D ACTION DATE BY DECLARATION OF COMPLIANCEWITH CODEOF I FOR OFRCE �.,., .,....-�..,....w...ao.—cry",,A ruin PFRMiTEXPiRFD AOMUKDLb941VA p 15ta*.TTEAaSAEStOSUMACAtION;Fd PERMITCANCELLED © CPA • ••• + +•• PERMITEXTENDED ❑ AOMD ❑ ASBESTOS NOTiRCADONiS NOT APPLICABLE TO PERMITFINAL 11 Z7 l PROPOSE0IM1'il1T/4�1. 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