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Home My WebLink AboutE2021-0094 - Permitswrf City of Newport Beach - Building Division c� �G 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 ��t1Y911FN1� Job Address: 434 GOLDENROD AVE Bldg: 1 Floor: Suite: Description of Work: ELEC-TEMP POWER POLE (x2021-0336) Inspector Area: 5 Legal Description: CORONA DEL MAR BLK 434 LOT 18 Owner: INJEV VAL Contractor: Address: 16 SILVERFERN Address: IRVINE , CA 92603 Phone: Phone: Con State Lie: Issued Date:02/16/2021 Lie Expire: Bus Lie: Processed By: G / Lie 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 Il iii iiiii iiiii iiiii liii iiiii iiiii iiiii 4 II GRAYSTONE CUSTOM BLDRS INC 3419 VIA LIDO STE 455 NEWPORT BEACH CA 92663 949-466-0900 971085 03/31/2022 BT30040057 03/31/2021 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 Plan Electrical Permit: E2021-0094 Project No: 0881-2020 Inspection Requests Phone (949)644-3255 NO CONSTRUCTION NOISE Code Edit: 2019 ON SATURDAYS Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9216106 Expire : 08/15/2021 q � fir.' d e FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 1 $41.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $37.00 Supplemental Fee: $0.00 Fee 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. DWNER-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 Sectioi 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 (J 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 an ployees' 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 comple ion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). LJ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, 1 apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor ❑ 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 y( sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I unc Professions Code, is available upon request when this application is submitted or at the following Web site: http://www.leginfi Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se ion 7 0) of and effect. License Class License No Date COMPENSATION DECLARATION FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL :OMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Tnance of the work for which this permit is issued. Policy No. eve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe nice carrier and policy number are: 7 Ir 1-� I Policy Number ie of Agent certify that, in the if I should becorr Iature of Applican permit is issued, I shall not employ any person in any manner s -,provisions of Section 3700 of the Labor Code, I shall forthwith �reby affirm under Oper9ty oAperjury that there is a construction lending agency for the performance of the work for which Ider's Name Lender's Address my signature below, I certify t each of the followin I am the property owner or aI Shorized to act o e props ow is behalf. I have read this application ai d the info ati I have pro ided correct. I agree to comply with all app icable city a oun es nd te-hdwsTelaing to building construction. I authorize representatives of this city or co t ant th e-identified property for inspection purposes. nature of Property Owner or Authorized Age Print Property Owner's or Autl and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). to completion of the improvements covered by this permit, I cannot that a copy of the applicable law, Section 7044 of the Business and In 3 of the Business a Ffessions ode.land my license is in full force Contractor Signa a �1 AND CIVIL FINES UP TO ONE HUNDRIfD THOUSAND DOLLARS 15100,0001, IN ADDITION TO THE Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date as to become subject to the worker compensation laws of California, and agree )mply with those provisions Date is permit is issued (Section 497, II Code). Date ACTION DECLARATION OF COMPLIANCE INITHFOOEOF / FOR OFFICEUSE ONLY FEDERAL REGULATIONS PART III OF TLE49RNC AQMD RULE 1403.ElISUBMiTTE06SBESTOSNCUFIa PERMITEXPIRED ITICNTO: ❑ EPA ❑ AQMO PERMIT CANCELLED PERMITIXTENDED FDAT&-�RY ASBESTOS P❑ROPOSED DEMOLITION. iIONfS NOT APPLICABLE TO ` PERMITFINAL 1�-L, CERTIFICATEOF OCCUPANCYISSU€D SIGNATURE: