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Home My WebLink AboutE2020-0569 - PermitsCity of Newport Beach - Building Division 111111111111111111111111Jill 11111111I11111111111111 Electrical Permit: E2020-0569 100 Civic Center Drive,. Newport Beach, CA 92660 In 2 0 2 0 0 5 6 9 Project No : 1519-2019 Permit Counter Phone (949)644-3288 Job Address: 914 OCEAN FRONT E Bldg: 1 Floor: Suite: Description of Work: ELEC -TEMP POWER POLE Inspector Area: Legal Description: BALBOA TR BLK 14 LOT 22 Owner: ATAII PAYAM CHARLES Contractor: Compensation Insurance Address: 24881 ALICIA PKWY #G Address: LAGUNA HILLS CA 92653 Phone: 949-637-1332 Phone: Con State Lic: Issued Date:10/14/2020 Lic Expire: Bus Lic: Processed By: Lic Exp Date: CARROLL RONALD L GEN CONTRACTORS INC P O BOX 7829 HUNTINGTON BEACH CA 92615 714-749-0622 682756 10/31/2022 BT30069597 11130/2020 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 20DA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: Inspection Requests Phone (949)644-3255 NO CONSTRUCTION WORK Code Edit: 2019 ON SATURDAYS Carrier: W/C EXEMPT Policy No: (NO EMPLOYEES) Expire : 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/remp Power: 0 $0.00 Temp Power Pole: 1 $41.00 Check Fee : Worker's INS:)LOTOR 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: $37.00 Supplemental Fee: $0.00 Fee Due at Permit PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m, to 6:30 p.m. and Srturday from 8:00 a.m. fa 6:GG N.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) 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 1e 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 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, Iusiness 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 n roved 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 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 legall, 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.htmi. ignature 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 Section 7000) of Division 3 of the Business a Mail de, and ice is in full force nd effect. p��/,� icense Class License No Date/V/(. I oG� Contractor Signatu� ✓ORKERS' 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 ($100,000), IN ADDITION TO THE OST 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 3760 of the Labor Code, for IN performance of the work for which this permit is issued. Policy No. I have 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date me of Agent Phone # rtify that, in the performance of the ork for which this it 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, I should become sub' o of ers' compens n p visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Si at of Applicant Da�' V CLARATION REGA ING ON CTI LEN I G AGENCY I hereby affirm under penalty o perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and co ces and state la relating to building construction. I authorize representatives of this city or count t h a ove-ide it operty for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam Date t1 0 ACT70N DATE BY DECLARATION OF COMPLIANCEM?TH CODE OF FOR OFFdCE USE ONLY rEDERAL REGULATIONS PART 61OF TITLE40AND AL MO RULE 1403. PERMITEXPIRED G I SUSNRTIED ASBESTOS NORFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NORTTCAAONIS NOT APPLICABLE TO PROPOSED DEMOLITION PERMIT FINAL _ _ _ CERTIFICATEOF OCCUPANCYISSUED -iAMATURE'