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Home My WebLink AboutE2021-0245 - Permits{; City of Newport Beach - Building Division L 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 u t'dl YY4)Y?;ja Job Address: 1611 KINGS RD Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE Inspector Area: 3 Legal Description: N TR 1219 BILK E LOT 44 Owner: STREIFF KIMBERLEE Contractor: Address: 1611 KINGS RD Address: NEWPORT BEACH CA 92663 Phone: Phone: Con State Lic: Issued Date:04108/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: *E2021-0245* a SANTANIELLO JAMES 3419 VIA LIDO #115 NEWPORT BEACH CA 92663 714-815-5097 361862 08/31/2022 BT30035015 03/31/2022 Electrical Permit: E2021-0245 Project No : 2180-2020 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: STATE COMP INS Policy No: 9266012 Expire : 01/01/2022 FEES New Construction Receptacle/Switch/Outlets MotorslTransformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $41.00 Issuance Fee: $37.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 TOTAL Fee : $78.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $78.00 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. DOWNER -BUILDER DECLARATION + I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the mason(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 Bvstness 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 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 ovi 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 frnm licensure under the Contractors' State License Law for the following reason: Ey 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 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 Frofeaciuns 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 Propert; Dwner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION II hereby affirm under Penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit S Clop 00) of Division 3 of the Business n Profess' ns Code, and my license is in full force and effect. Liotnae Class — License No pate Contractor Signature WORKHRS' COMPENSATION DECLARATION WARNING: FAILURE TO SECT IRE 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 GCS- I ^OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0700 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. I hi-elay affirm c'19^r 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 forwhich 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 ifrsuLance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance of the VefAt for which this permit is issued, I shall not employ any person in any manner so as to become subject to the worke tom nsation laws of California, and ogre that, if I should become 1e t to thew ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro isi ns. Signature of Applicant Dat DECLARATION REGA STRUCT N LENDING AGENCY I hereby affirm under p alty 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. iL I have read this application and the information I havep v ad is correct. I agree to comply with all applicable city and county rdin ces and state laws relating to building construction. I authorize representatives of this city or county t Titer a ve- ntified property for inspection purposes. T Signature of PropertyOwner or Authorized Agent Print PropertyOwner's or Authorized Agent's Name Date ACtitNi i1A7F 13Y DECLARATION OF COMPLIANCE 7N CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQitSD RULE 1403. PERMIT EXPIRED ❑ / SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NDBRCA710Nf5 NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL —2 CERT{FICATEOF 5tGNATURE:. OCCDPANCY{SSUED