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Home My WebLink AboutE2021-0562 - Permits9,wnr}, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2021-0562 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 5 6 2 Project No : 0794-2021 s,`., Permit Counter Phone (949)644-3288 `�^�cerna�*a Inspection Requests Phone (949)644-3255 Job Address: 25 BURNING TREE CIR Bldg: 1 Floor: Suite: Description of Work: SFR TEMP POWER POLE (X2021-0860) -- - Inspector Area: 4 ® Code Edit: 2019 Legal Description: N TR 7638 LOT 50 CD Owner: STERN BRIAN & DEBBI Contractor: PATTERSON CONSTRUCTION: yWorker's Compensation Insurance Address: 1956 PORT CARDIFF PL Address: 15 CORPORATE PLAZA STE.150 V 1-q-� Carrier: STATE COMP , „ e•.00� NEWPORT BEACH, CA 92660 NEWPORT BEACH CA 92660 1 �' Policy No: 9065406 , o Phone: Phone: 949-723-1800 Expire :08/01/2022 0000 • . . •• o Con State Lic: 802367 _..-.1 °,,,,® a• Issued Date:09/08/2021 r Lic Expire: Bus Lic: 0713112022 BT02110534 7 0 °„°,• 000 ••.o. Processed By: 11 Lic Exp Date: 09130/2021 "ti r • • ®� o .A./ ®• oo.00. New Construction Receptacle/Switch/Outlets Residential 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 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20DA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1 DOOA: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL FEES 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 Back/Temp Power: 0 $0.00 Temp Power Pole: 1 $41.00 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: $38.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : 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 reasons) 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 Iicensure 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 (_) 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 A was not built or improved 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 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 Iicensure 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 LV& Lhave 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 Ctd%,j%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 L•IC'E 4SED GMTRACTOR'S DECLARATION I hereby affirm Jn a� penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se tio® n 7 00) of Division 3 of the Business and Professions Code, and my license is in full force and effect. • �s� 'License Class •••• License No Date � '�'Zf Contractor Signature 49FNERS' C(7MPENSATION DECLARATION y� WARNING: FAILURE-r 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 To"diF COMPEthill, Q% DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. lilvereby affirm under penalty of perjury one of the following declarations: Wiue and will •Mtain 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 ance of11wS,% rk for which this permit is issued. Policy No. and Wy I:g tpjain 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 pelicy number are: Policy Number of Agent Date 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 if I should becom,J$ subje to the ww�oorrlLgr�s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisiooPS. lature of Applicant(..I ' ' _ Date O `/� /7'eZ) CLARATION REGARDING CONSTRUCTION LENDING AGENCY �reby 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 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. 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. I authorize representatives of this city or county to eryt5pJhe9 above, property for inspection purposes. of Property Owner or Authorized Name Civil Code). , and q— ACTION DATE RY DECLARATION OFCOMPLIANCE t4RTHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 1403. PERMITEXPIRED ❑ ISUBMITTED ASBESTOS NOTIFICATION 'TO: ❑ EPA ❑ AQMD PERA41T CANCELLED PERMITEXTENDED ❑ ASBESTOS NOTiRCATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL - `I - ( CERTIRCATEOF SIGNATURE., OCCUPANCYtSSUED