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Home My WebLink AboutE2020-0124 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1113 KINGS RD Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE (X2019-3305) Inspector Area: 2 Legal Description: N TR 1219 BILK E LOT 31 Owner: REED GREG & CAROLYN Contractor: Address: PO BOX 1245 Address: NEWPORT BEACH, CA 92659 Phone: 949-698-2091 Phone: Con State Lic: Issued Date:02/28 2020 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 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: LEGACY C D M INC 2618 SAN MIGUEL DR #204 NEWPORT BEACH CA 92660 949-677-3650 962720 04/30/2021 ST30043218 05/31/2020 Rece ptac l el 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: E2020-0124 Project No : 2295-2019 Inspection Requests Phone (949)644-3255 Code Edit:2019 11 � LECTUOR Worker's Compensation Insurance Carrier: STATECOMP. INS Policy No: 9147240 Expire : 11/24/2020 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 Backriemp Power: 0 $0.00 Temp Power Pole: 1 $39.00 Plan Check Fee : Temp Underground: 0 $0.0u Sub Panel: c $0.00 ''e' ' $0.00 0 $0.00 Record Mgmt Fee: ' ' $0200 Plan Check Fee: $0.00 Investigation Fee: $C:00 Issuance Fee: $35.00 Supplemental Fee: Fee Due at Permit Issuance : 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 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 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 licensure 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.leginfo.ca.gov/calaw.html. 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 th Business and Professions Code, and my license is in full force and effect. License Class License No Dte 2_ t4-" 22 Contrac Signature WORKERS' COMPENSATION DECLARATION IF 1% WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 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, 'arm df the vork for which this permit is issued. Policy No. 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' Trance caemer cnd policy number are: Policy Number issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for Date T,=`of Agent _ _ Phone # certify that, Ir 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, fi I shou d become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature IJlica It DAK L f CLARATI F.EGARDI CONSTRUCTION LENDING AGENCY , a,eb`v affirm under panalty 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). tderfa Name Lender's Address TY xignature, below, I certify to each of the following: I sm the pripedy 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 to enter the above -identified property for inspection purposes. 1 11Signature of Property Owner or Autho w d Agent Print Property Owner's or Authorized Agent's N' a /"1 `-C/ C Dite 1-1 t8—/-0 I ACTION DATE BY DECLARATION OF COMPLIANCE MTN CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OFTITLE40AND AQMD ROLE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATIONIS NOTAPPLICAELE TO PROPOSED DEMOLITION. PERMITFINAL IO- O PM a:eus CERTIFfCATEOF SIGNATURE: OCCUPANCYISSV ED