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Home My WebLink AboutE2022-0204 - PermitsCity of Newport Beach - Building Division IIIII�IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 2 0 2 0 4 Permit Counter Phone (949)644-3288 Job Address: 1528 KEEL DR Bldg: 1 Floor: Suite: Description of Work: ELECTO FIRE PITS Inspector Area: 6 Legal Description: N TR 6152 LOT 116 Owner: ANDERSON TIMOTHY Contractor: Address: 1528 KEEL DR Address: CORONA DEL MAR, CA 92625 Phone: Phone: Con State Lic: Issued Date:04/04/2022 Lic Expire: �() Bus Lic: Processed By:��i-c Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20DA: 0 $0.00 0-600V over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 11%, J'%:34E C T i CIS CONSTRUCTION-INC', PO BOX 12109 COSTA MESA 92503 949-285-8326 1021012 11/30/2022 BT30069027 09/30/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 2 $3.50 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Electrical Permit: E2022-0204 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9224879 Expire : 01/24/2023 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: 0 $0.00 Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: •••• 0 0 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $38.00 $0.00 11 TOTAL Fee: $41.50 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $41.50 11 PERMITS EXPIRE 160 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. 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 checkmark(s) I have placed next to the applicable item(s) iection 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 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 of more than five hundred dollars ($500). 1, as ownPJrllf 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, usiness antd PfgfrAsions 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 nprcvements 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 V4ved for'tile qurpose of sale). J, 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 ppbRto 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). J am exeApT from licensure under the Contractors' State License Law for the following reason: y 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 eil a structule"it 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 Mtt4sions Code! imvailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. 1grPature of Property Owner or Authorized Agent Date 49EVSED rONTRACTOR'S DECLARATION hereby affirrll ygderbenalty of perjury that I am licensed under provisions of Chapter 9 (commencin ith Section 7000) of Division 3 of the Business a d Profes ' Code, and my license is in full force u4 vVect. ij:JQAClassJ •J� License No Dat Z Contractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: 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 I$100,0001, IN ADDITION TO THE DST 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 th, 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 Date Name of Agent Phone # I certify that, in the perfor ante 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 agre that, if I should becom But u lect to the orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those proves IIpns. Signature of Applicant Date �X LZ Z DECLARATION REG N CTION LENDING AGENCY I 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 (Se ion 3097, Civil Code). Lender's Name Lenders Address By 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 cou y ordinances and state laws relating to building construction. I authorize representatives of this city or coun o ant a bove-identified property for inspection purposes. Signature of Property Owner or Authorized Age Print Property Owner's or Authorized Agent's Nam '�� 6vsT.-'.- Date ?Z ACTION DATE BY DECLARATION OF COMPLIANCE MTN CODE OF V FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40AND AOMD RULE 1403. ❑ / SUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMtTEXPIRED PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSEODEMOLITION. SIGNATURE: - PERMIT FINAL -(� -2 Z. D �s� CERTIFICATE OF OCCUPANCYISSUED