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Home My WebLink AboutE2020-0110 - Permitssty WAVR City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 F n Permit Counter Phone (949)644-3288 a i�4rntiNa Job Address: 1700 GALAXY OR Bldg: 1 Floor: Suite: Description of Work: ELEC INSTALL (2) OUTLETS FOR BBQ AND FIREPIT Inspector Area: Legal Description: 3 N TR 4224 LOT 42 Owner: MALTS ANDREA & GARY Contractor: Address: 1700 GALAXY DR Address: NEWPORT BEACH, CA 92660 Phone: 520.360-7843 Phone: Con State Lic: Issued Date:02/24/2020 Lic Expire: M/� 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 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/Hto U/G 0 $0.00 rr IIIII IIIIIIIII IIIII II 0 IIIIIIIIII II NEWCASTLE LANDSCAPING 17584 SANTA CRISTOBAL STREET FOUNTAIN VALLEY, CA 92708 714-624-6662 819236 04/30/2021 BT30071150 02/28/2021 Receptacle/Switch/O uti ets Receptacles/Outlets: 2 $2.00 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: E2020-0110 Project No: 2681-2019 Inspection Requests Phone (949)644-3255 f ��C-r®R Code Edit: 2019 Worker's Compensation Insurance Carrier: REPUBLIC UNDERWRITERS° Policy No: FLA00555502 .... Expire : 05/01/2020 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 Plan Check Fee : " Temp Underground: 3 $c.cc 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: $35.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : $37.00 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. JWNER-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) (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 subject: -the applicant to a civil penalty of r not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) 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 it was not built or improved 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 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 1 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 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED COf4i :?ACTOR'S DECLARATION I hereby affirm unJU-I penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 700 ) of Division 3 of the Busi ss and Pr s' ns Co e, and my license is in full force License Class �. License No Z3 to Contractor Si VIOFKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SE^URE 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 COST OI COMPENSATION1, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I ;iereJy affirm under penalty of perjury one of the following declarations: 111 hav: and will r•irintain 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 pei fUlrciance of the work for which this permit is issued. Policy No. 1avE and will mai,rtain 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' compensatiol surancec rr r�^rryLpc�' are: �>3W��Z ISt_0 Expiration F—tir' Policy Numbe Ex iration Date of Agent in the performance of the for which this permit is issued, I shall not employ any person in any manner so as to become subject to the become subject to th ork s' coglpensation provisions•of Section 3700 of the Labor Code, I shall forthwith comply with those pr�ns. CLARATION REGARDING-00WRUCTION LENDING AGENCY �reby affirm under penalty of erjury that there is a construction lending agency for the performance of the work for which this permit is ider's Name Lenders 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 D 14wlzes and state laws relating to building construction. I authorize representati this city or county topKerYe ab e-identified property for inspection purposes. A-f Print Prooertv Owner's or Authori d Agen ACTION —r--- UATE� _ BY PERMIT EXPI RED PERNHTCANCELLEO PERMIT EXTENDED PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED PART 61 OF TITLE40 AQMD RULE 1403. ❑ 1 SUBMITTED ASBESTOS NONFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIRCA77ONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: compensation laws of California, and I /7 0 3097, Civil Code). V,5