HomeMy WebLinkAboutE2023-0298 - Permitsuq,.
City of Newport Beach
Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
1111111111111111111�11111111111111111111111111111111 jj Electrical Permit : E2023-0298
Plan Check No : 0918-2022
Work Class : Other
Issued Date : 04/03/2023
Inspection Area : 6
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 1205 KEEL DR Legal Desc :.IN TR 6634 BLK LOT 92
Description : ELEC - SFR INSTALL (1) TEMP POWER POLE
Owner: KEEL CUSTOM HOME LLC
Address : 530 TECHNOLOGY DR STE 100 IRVINE, CA 92618
Phone : (949) 395-5055 -
Applicant : KEEL CUSTOM HOME LLC
Address : 530 TECHNOLOGY DR STE 100 IRVINE, CA 92618
Phone : (949) 395-5055
Owner/Builder : KEEL CUSTOM HOME LLC
Address: 530 TECHNOLOGY DR STE 100 IRVINE, CA 92618
Phone : (949) 395-5055
Code Edition : 2022
Type of Construction :
Building Setbacks : Front: 7, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY:
SPECIAL CONDITIONS: O/B FORM ATTACHED
Contractor
Address
Phone :
Con State Lie
Lie Expire
Bus Lie:
Bus Lie Expire:
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Fire Hazard Zone : NO
Occupancy Groups :
r'
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 bythe checkmark(s) I have placed next to the applicable items)
Section 7031 5, Business and Professions Code: Any city or county that requires a seem!( to Construct, alter, improve, demolish, or repair anystructure,$)nor to its Issuance, also requires the applicant for
ae permit to file a signed statement that he or sheds licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division of the Business and
'rofeasions Code) or that he or she is exempt from licensors 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 ponafty of
at more than five hundred dollars ($500).
1 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (,j portions of the work, and the structure is not intended or offered for sale (Section 7044,
tus'iness 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
nprovemenis are not intended or offered for sale. If, however, thebuilding 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 vet for tine purpose of sale).
f, Be owner of the property, am exclusively Contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code:. The Contractors' Stale License Law does not
€y 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 licensore under the Contractors' State License Law for the following reason
ly my signature below t acknowledge that, except for my personal re "donca in. which I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legal)
all a structure that I have built as an owner -builder If it has not b on clad In Its anti y by Ilconsod Contractors. I understand that a copy of Inc applicable law, Section 70" of the Business and
'rofessions Coda Is available upon request when this appl` lip l u.. ad or at the following Web Site:http:JJwww,Iaginfo.ea.govicpiaw.ntml.
Ignature of Property Owner or Authorized Agent ....... Date q' 3' a3
,ICENSED CONTRACTOR'S DECLARATION
hereby'affirm under penalty of perjury that l am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,. and my license is in full force
nd effect. License Ciass License t Date Contractor Signature
WORKERS'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
DST OF COMPENSATk0N DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under nenafty of perjury one of the following declarations:
1 ha"e and ,v.l 15aintam a certificate of consent to self-4nsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for Ih
erformanCe of he vC,L for which this permit is Issued. Policy No.
-0 havc 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' compensatior
surance, carriar xit policy number are:
Policy Number
of Agent -__„_
Date
certify that, in the performance of the work for which this permit is Issued, f shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code_ I shall forthwith comply with those provisions.
nature of Auui.cani n.....
I Lareby a+firm 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 Codify to each of the following:
I am the property owner or authorized to act an the property owner's behalf,
I have read this application and the information I have pro. ids is correct.
I agree to comply with :all applicable city and county in late laws relating to building. construction.
I authorize representatives of this city or county to ter t a dentifled property for inspection purposes. '�,/)
Signature of Pro ert Owner. or Ault orizedA ant print Property,pOwner's or Authorized Agent's Name i ICA 1Uvv pate ¢ �3
ACTION DATE BY DECLARATION0 OiviP NCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
i REGULATIONS PART 61 OFTITIE 40ANDAOMORULE
1403
ASBESTOS NOTIFICATION TO
PERMITFRNL p# 5BESfO$NOr T N5 0'A LICABLE TO
CER IOCATE OF 4/—/1 ,I pby 11 OSCID DEMOL N
OCCUPANCYISSUEO M M i SIGNATURE_ _