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Home My WebLink AboutE2021-0749 - PermitsCity of Newport Beach - Building Division 11111111111111p11111p11111111111p111111111111111111 .� 'tee 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 7 4 9 �. Permit Counter Phone (949)644-3288 u y ¢ �'a C3yr11A>'�� Job Address: 430 TUSTIN AVE Bldg: 1 Floor: Suite: Description of Work: ELEC -TEMP POWER POLE (X2021-2966) Inspector Area: >( 3 Legal Description: FIRST ADD TO NEWPORT HEIGHTS BLK 26 LOT 8 Owner: 430 TUSTIN LLC Address: 790 NEWTON WY COSTA MESA CA 92627 Phone: Issued Date:11/01/2021 Processed By: 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 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: Contractor: SEPULVEDA BUILDERS INC Address: 790 NEWTON WY COSTA MESA CA 92627 Phone: 714-222-1150 Con State Lic: 695401 Lic Expire: 10131/2022 Bus Lic: BT30058100 Lic Exp Date: 02/28/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 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: E2021-0749 Project No : 2573-2021 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: NO EMPLOYEES Policy No: Expire AN I OR 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 Plan Check Piggy Back/Temp Power: 0 $0.00 Temp Power Pole: 1 $41.00 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 e at Permit Issuance : $79.00 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. OWNER -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 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 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, 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 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 legal) 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.leginfc.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I 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 and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signatu WORKERS' COMPENSATION DECLARATION WARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 performance of the work for which this permit is issued. Policy No. ❑1 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: Jhif er Policy Number Expiration Date a of Agent Phone # certify that, in the performance 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi.Litsion`yy Signature of Applicant i Dat>?Y 471I1 DECLARATION REGARDI R 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 (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 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 count ordinances and state laws relating to building construction. I authorize representatives of this city or county to an ve-ide property for inspection purposes. - / Signature of Property Owk Iner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date �' ACTION DATE BY DECLARATION OF COMPLIANCEWITN CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF Tf 71E40 AND AQMD RULE 1403. PERMLT EXPdft€D ❑ I5UliM1 iTEGHSf3E57 GS N0:7: !CATION TO: ❑ Epp ❑ ADA'D PERMITCANCELLED P€RM7T €X7EAIDED ❑ ASBESIUS NOTIFICATION IS NOT APPLICABLE F0 PROPOSED DEMOLITION. PERMIT FINAL (_ CERT7FICATEOF OCCDPANCYF35DED 51GNAT+7t2F: