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Home My WebLink AboutE2022-0150 - PermitsCity of Newport Beach - Building Division a 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 609 DONALD PL Bldg: 1 Floor: Suite: Description of Work: ELEC TO BBQ Inspector Area: 3 Legal Description: N TR 10156 LOT 1 Owner: MILLER ROBERT Contractor: Address: 609 DONALD PL Address: NEWPORT BEACH, CA 92663 Phone: Phone: Con State Lic: Issued Date:04/05/2022 Lic Expire: Bus Lic: Processed By: Lic 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 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $41.50 II I'IIIIIIII2IIII1�� Iu�0 II RICK DORN CONST P O BOX 10047 WESTMINSTER CA 92685 714-585-7322 357535 05/31/2023 BT30074323 02/28/2023 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: E2022-0150 Project No : 0654-2022 Inspection Requests Phone (949)644-3255 f� V`_ Code Edit:2019:. Worker's Compensation Insurance Carrier: STATE COMP INS. Policy No: CWC00207000 Expire : 09/28/2022 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 06 G ®Ee. o Temp Underground: Sub Panel: .0 $0g.55g00 ea .9 $16W 4.e $0.00 Record Mgmt Fee: ., s&0'0 �� Plan Check Fee: ; '®.' $0.66" Investigation Fee: $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : $41.50 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. IWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s)l indicated below by the checkmark(s) I have placed next to the applicable itern'�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 is 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 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 of more than five hundred dollars ($500). 3 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions) of the work, and the structure is not intended or offered for sale (Section 7044, Iusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throggh 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 c mpletion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). J I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 71 pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contre I I am exempt from Iicensure 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 c ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.1 lignature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70C nd effect. / .icense Class License No Date VORKERS' COMPENSATION DECLARATION rARNING: FAILURGV9EEPIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PI PST OF COMPENSWIOd4,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. Mtey-affrm Ixrde►penalty of perjury one of the following declarations: 1 have and will 6?ntain a certificate of consent to self -insure for workers' compensation, issued by the Directi WAnce of thework for which this permit is issued. Policy No. �have and wild maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for tf isureace carrier'Erht policy number are: ;ewer, ;': ' Policy Number Jjcer:fy that, iy the performance of the wor or which this permit is issued, I shall not employ any person in any me iat, if I•shouldbecomo subject to the rs' ompensation provisions of Section 3700 of the Labor Code, I shall foi ....� •. e anatwe of Applicant Wi' kRATION.W04RDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for .ender's Name Lender's Address ly 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 o enter a Identified property for inspection purposes. signature of Property Owner or Authorized Ageryt� �� Print Property Owner's Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year prior to completion of the improvements covered by this permit, I cannot understand that a copy of the applicable law, Section 7044 of the Business and Date of Division 3 of the Business and Professions and my license is in full force 2 Contractor Signatul€ ,LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date so as to become subject to the workers' compensation laws of California, and agre, i comply with those provisions. /� I Date,,----' this permit is issued (Section 3097, Civil Code). Authorized ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFRCE USE ONLY FEDERAL REGULATIONSPART 61 OF TITLE40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTEDASBESTOS MO�FICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMiTEXTENDED ❑ ASBESTOS NOTIFICA770MISNOTAPPVCABLETO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED