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HomeMy WebLinkAboutE2018-0341 - Permits���.t � City of Newport Beach - Building Division IhIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II •m• ee ee e o eo �,t. 4` 100 Civic C �nterDrivelNewporto6®ac�i, G�i+82660 E 2 a 1 8 0 3 4 1 H, '' s Permit Counter Phone (449)&44:32531 m m ,.: n o ...•• e• %. o e ••e • • o• Job Address: 187 Description of Work: Inspector Area: 5 Cliff RIO 61d§: 1 Flrgor: I ; Suite, FUGGY TACK•METEW('X2096-3734) Legal Description: N TR 1116 LOT 102 Owner: PERKINS KEN Contractor: Address: 416 POPPY ST Address: CORONA DEL MAR CA 92625 Phone: 0 Phone: Receptacle/Switch/Outlets Residential Con State Lic: Issued Date:05/10/2018 Receptacles/Outlets: Lic Expire: $0.00 Multi -Family: Bus Lic: Processed By: Fixtures: Lic Exp Date: $0.00 J 0 AHLKE ROBERT M CO 1135 GRANVILLE NEWPORT BEACH CA 92660 949-290-6376 473941 05/31/2019 BT30033322 10/31/2018 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: 0 $0.00 $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 1 OOOA: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: Electrical Permit - E2018-0341 Project No : 1273-2016 Inspection Requests Phone (949)644-3255 At �n t� Code Edit: 2016 Worker's Compensation Insurance Carrier: LAKE FIRE CASULTY COMP. Policy No: FLA003181 Expire : 01/01/2019 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 Backrremp Power: 1 $36.00 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 Fee Due at Permit Issuance: 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, 1 )WNER-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 cbecknerk(s):I have plaered need 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 anj stjuctur@, fiol tc its•is&aace, ®Iso requires the applicant for he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (corrfntenIcMg with Section 7000) bf 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 lot 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 c�rvcture.is not.i *tendcd-or � fferetl fir sale (Section 7044, 3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or perybpal ejfort,'bu0dsor 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•Bdildg;yill ha0e„ thebypien oT prbvi%that it was not built or Tlproved for the purpose of sale). 1, 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 Ipply. 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: 3y 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, Icannot legally ell 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 rrofessions 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 -ICENSED CONTRACTOR'S DECLARATION 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 Profesysion>s Code, an my licenseiii n full force Ind effect. .icense Class License No Dateoe Contractor Signature\� VORKERS' COMPENSATION DECLARATION 1ARNING: 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 ;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. 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' carrier and policy number are: Policy Number Expiration Date of Agent ]I certify that, in the performance 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 iat, if I should become �s/pbject t�o'tF/�vorkerrs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /� signature of Applicant 4 /[ /&<— Dat IECLARATION REGAADAQG CONSTWILICTION LENDING AGENCY 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 (SEC ion 3097, Civil Code). tinder's 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 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 ordina nd stat aws relating to building construction. I authorize representatives of this city or count t ant ab Id Ified operty for inspection purposes sicnature of Prooertv Owner or Authorized Apent y__ Print Property Owner's or Authorized Agent's Name ACT70N DATE BY uc�crtrwrtviY yr l.vAvrurrlNt.c rvirn wuca�r FEDERAL REGULATIONSPART 61 OF Tt7LE40AND PERMITEXPIRED AQMDRULE9403. i SUBMITTEDASBESTOS NODFICATION TO: PERMITCANCELLED ❑ EPA P€RMiT EXTENDED ❑ AQMD 0 ASBESTOS NOT APPLICABLE TO PERMITFINAL 1h It5 l � OPOSED QE IOLITION.TtONtS OCCUPANCYISSUED SIGNATURE: