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Home My WebLink AboutE2023-0395 - Permits4 �EWPO,gr City of Newport Beach D A� Community Development Department- Building Division '* 100 Civic Center Drive, Newport Beach, CA 92660 n Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 00. newportbeachca.gov/inspections iiiiiiiiiii II Electrical Permit : E202,3-0395 Plan Check No : 0092-2022 Work Class : Other Issued Date : 04/28/2023 Inspection Area : 1 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 : 215 61 ST ST Legal Desc : N TR 772 BLK 1 LOT 2 TR 772 LOT 2 BLK 1 AND SWLY 4 FT LOT 3 BLK 1 Description: ELEC UPGRADE ELECTRICAL MAIN SERVICE PANEL 200A Owner: VIRGINIA KOONTZ Address : 215 61 ST ST NEWPORT BEACH, CA 92663 Phone: Applicant: JASON BLACKMORE Address : 600 ANTON BLVD, 11 FL COSTA MESA, CA 92626 Phone: (949)274-6585 Owner/Builder Address Phone : Code Edition : 2022 Type of Construction : Building Setbacks Flood Zone Use Zone: PROCESSED BY: SPECIAL CONDITIONS: Front: 5, Side: 3, Side: 3, Rear: 5 X R-1 - Single -Unit Residential (3or Contractor : MAKER DESIGN Address : PO BOX 12996 NEWPORT BEACH, CA 92658 Phone: (949)434-7626 Con State Lie : 1020387 Lie Expire : 11/30/2024 Bus Lie: BT30074592 Bus Lie Expire:03/31/2024 Workers' Compensation Insurance Carrier: EXEMPT Policy No : EXEMPT W. C. Expire: Fire Hazard Zone : NO Occupancy Groups : R3/U 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 items) (Section 7031.5, Business and Professions Cade: 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 g (commencing with Section 7000) of Division 3 of the Business and Professions Cods) or that heor she is exempt from lioensure 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 (_) portions of the work, and the structure Is notintended 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). 111, 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 anowner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuantto the Contractors' State License Law). ❑ 1 am exempt from licensors under the. Contractors' State License Lew for the following reason: By my signature below I. acknowledge that, except for my personal residence in which I must haveresided for at least one year prior to completion of the improvements covered by this permit, I cannot legal soil a structure that I have built as an cwner-builder if it has not been constructed in its entirety by licensed contractors. 1 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:/,lww .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 previsions of Chapter g (commencing with Section 7000) of ivi ion 3 of the Business and Profess' n, od Sint I force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION 57 ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUS'Agb DOLLARS IS100,0001, IN ADDITION OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3704 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will ma+main 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 brmance of the work 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' compensa� Prance carrier and policy number are: Policy Number Exp€vatic of Agent Phone # Date :ertify that, in the performance of the work for whin permitis issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree if I should become subject to the workers' en iori-pRq&II Gf Seolion 3700 of the Labor Code, I shall forthwilh comply with those provisions, nature of Applicant CLARATION REGARDING CONS TION I-EtON110 AGEN . my signature below, I certify to each o the following: I am the pmpe-t7 :r,vner or authorized to act on the property owner's behalf. I have read the^ 9T, Iication and the information 1 have provided is correct. f cg-re to co'r Iy with all applicable city and county ordina as-artrYs! to la_ € authorize reprPsan+at➢vas of this city or county toe rfhe above nature of ProoerN Owner or Authorized Aoent PERMIT ;'ER.+IIT CXTENDEG PERM1T FfNAL ,'ERTWFC.9TE Or OCCUPANCY ISSVEr g to building construction. for inspection purposes. OF COMPLIANCE WITH CODE OF FEDERAL PART 91 OF TITLE 40 AND AOMD RULE I,..I ASBESTOS NOT IS NOT APPLICABLE 10 PROPOSED DEMOLITION FOR OFFICE USE ONLY Date,�zT�'�23