HomeMy WebLinkAboutE2022-0364 -�gwrr,�,T City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 1227 MARIAN LN Bldg: 1 Floor: Suite:
Description of Work: ELEC -TEMP POWER POLE
Inspector Area: 3
Legal Description: N TR 1973 LOT 41
Owner: KLIEWER WENDI
Contractor:
Address: 1227 MARIAN LN
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Con State Lic:
Issued Date:06/15/2022
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
Over 600V or 1000A: 0 $0.00
O/H to U/G 0 $0.00
TOTAL Fee : $79.00
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ESTATES GENERAL CONT
PO BOX 335
SILVERADO CA 92679
714-448-9823
958012
02/28/2023
BT30042497
03/31/2023
Receptacle/Switch /O u t I ets
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 : E2022-0364
Project No : 0403-2022
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: PREFFERRED PRO INSUR
Policy No: ON0975403
Expire : 04/29/2023
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 Backfremp Power: 0 $0.00
Temp Power Pole: 1 $41.00
IN"SI E�TFI
Temp Underground:
0
$0.00
Sub Panel:
0
$0.00
0
$0.00
0
$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Issuance Fee:
$38.00
Supplemental Fee:
$0.00
Fee Due at Permit Issuance :
$79.00
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.
)WNER-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 7C31.5, 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 appicant for
is 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 Businesrand
'rofessions 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
of more than five hundred dollars ($500).
7 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
nproved for the purpose of sale).
1 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
pply 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 Iicensure under the Contractors' State License Law for the following reason:
iy 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]
ell 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
Irofessions 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 Property Owner or Authorized Agent ate
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) of Division 3 of the Business an rotes ons Co and my lit@nse is in full force
nd effect.
.icense Class License No Date IS l2 Contractor Signatur
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE AND DOLLARS ($100,000), IN ADDITION TO THE
'DST OF COMPENSATION, 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:
7 I hie 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
@rogfiance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
umber Expiration Date
is of Agent
certify that, in the perfor nce of th ork faiwhich this perAt is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre
t, if should become sub' ct to the rkers' compensation pro sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant \ j Dated LE xr�2'Z
CLARATION REG G CON TRUCTION LENDING AGENCY
;reby affirm under pen t of perju ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the pr ner'a behs
I have read this application and the information h e pro de is correct.
agree to comply with all applicable city and co ty ord' antes no state
I authorize representatives of this city or coun to ent r the abo-�dentifi
ACTION I DATE
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTFfCATE OF
OCCUPANCYfSSUED
relating to building construction.
aperty for inspection purposes.
Print ProDertv Owner's or Authorized Aoent's Name
FEDERAL REGULATIONS PART 51 OF TITLE 40 AND'
AC.MD RULE 1403.
❑ 1 SUBMITTED ASBESTOS NOTIFICATIONTO:
❑ EPA
❑ AOMD
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SI(=NP TURE:
Date
FOR OFFICE U5E ONLY