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Home My WebLink AboutE2022-0018 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 `.. Permit Counter Phone (949)644-3288 r'a Gtytiti�ty Job Address: 223 JASMINE AVE Bldg: 1 Floor: Suite: Description of Work: ELEC /BBQ Inspector Area: S Legal Description: RESUB OF CORONA DEL MAR LOT 23 BLK 136(AND NELY 10FT LOT 21 BLK 1 36 Owner: BRINTON STEPHANIE Contractor: Address: 223 JASMINE AV Address: CDM CA 92625 Phone: Phone: Con State Lic: Issued Date:0412712022 Lic Expire: ,,y Bus Lic: Processed By:- (t �L/ Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: MITCHELL PARKS 1400 S SUNKIST ST #190 ANAHEIM CA 92806 949-279-7193 838091 05/3112024 BT30078593 04/30/2023 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: E2022-0018 Project No:0132-2022 Inspection Requests Phone (949)644-3255 Code Edit: 2019 2! 0 ''J Worker's Compensation Insurance rl Carrier: NO EMPLOYEES Policy No: Expire 0y DJ 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 Backrremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Fee : $0.00 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 : $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° AW..Saturday °rom 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) 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 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 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 owner Of 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 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 I am exempt 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 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 'rofessions Code, is 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 .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti n 7000) o Division 3 of the Business and Prof ssion del d my tense' -'full force nd effect. icense Class License No DateContractor Signatur VORKERS' COMPENSATION DECLARATION DARNING: 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 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, eff4rmance of the work for which this permit is issued. Policy No. 0 have and will al ain workers' co nsation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio trance carries policy number ar . Tier P Expiration Date ne of Agent Phone # certify that, in the perfor nce a wo or ich rmit is issued, I shall not employ any person in any manner so as to become subject to the workers' cgggRRRIIIpensation laws of California, and agre t, if I should become su e t to t wor IS' mpe n provisions of Section 3700 of the Labor Code, I shall forthwith complywith those p ovisions. nature of Applicant CLARATION REGA TR LENDING AGENCY :reby affirm under pe alty of erjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 be I have read this application and the information I ktere is cc ct. I agree to comply with all applicable city and counstag ws r Ing to building construction. �' 42 I authorize representatives of this city or County t-id �rRifie o rty for inspection purposes. Al 21 nature of ProperttOwner or Authorized Agent Print Property Owner's or Authorized Agent's Name / ACTION DATE BY DECLARATION OF COMPLIANCE KITH CODE OF FOR OFFICE USE ONLY FECEPtL REGUI /ITIONS PART 61 OF TITLE40AND AUMD IULE 140. PERMIT EXPIRED _._ - ❑ i-SUEMIT`EDASBESTOS NOIIFICARON TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS N077FICATIONIS NOT APPLICABLE TO PROPOSED DEA40LITION. PERMIT FINAL - CERTIFICATEOF SIGNATURE: _ OCCOPANCYISSU€D