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Home My WebLink AboutE2021-0687 - PermitsCity of Newport Beach - Building Division Illll(I(Illlllllllllllllllllllllllllllllllllllllllllllll(I r,� r . , 100 Civic Center Drive, Newport Beach, CA 91660 "� Permit Counter Phone (949)644-3288 a�» n Job Address: 804 PARK AVE Bldg: 1 Floor: Suite: Description of Work: SFR UPGRADE EXTG SERVICE/SUB PANEL SEP CIRCUITS Inspector Area: 2 Legal Description: BALBOA ISLAND SEC 2 LOT 1 BLK 9 W 40 FT Owner: HARRINGTON BRUCE Contractor: Address: 804 PARK AVE Address: NEWPORT BEACH, CA 92662 Phone: Phone: Con State Lic: Issued Date:10/11/2021 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: 1 $47.00 0-600V over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $135.00 Electrical Permit: E2021-0687 Project No : Inspection Requests Phone T.610 44 3255 41, Code Edit: 2019 O CONSTRUCTIOi�6� �*,g THOMAS ELECTRIC V�7oPcetipensation Insurance 2361 FORDHAM DR Carrier: EXEMPT COSTA MESA CA 92626 Policy No: 401360 2935 Off( THE WEEKEND Aire 401360 03/31/2023 BT30076874 10/31/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 3 $21.00 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 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 Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee: $0.00 Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: 0 0 90000A a aaao OOUCiU O 0 0 0 o c o�aooa o a UU3aa O oao0o 0 UC000 $0.10 '_ 0 $29.00 $0.00 $0.00 $0.00 $0.00 $0.00 $38.00 $0.00 Fee Due at Permit Issuance: $135.00 PERMITS EXPIRE 180 DRYS 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 5:00 p.m. 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 item(s) (Section 7031.5, Bus,;iness,'',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�',Il a 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 huhdred' dollars ($500). ❑ I, 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, 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 11 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 forthe'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 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 licensure under the Contractors' State License Law for the following reason: By my signature below h 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 Iegall, sell a structure that I havelbuilt 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 Professions Code, is 'available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govfcalaw.htmI. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I herebyaffirm urider'°enal of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professions Code, and my license is in full force P tY P 9 n' P P ( 9 ) Zr`�C-e�f.°rt. �B�� License�Class ! License No `�U t 3 [Q t`i' Date l q I Z, Z 1 Contractor Signature , !!ViORRFRS' COMPENSATION DECLARATION hARN Na: 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 CCcST OF COMPENFkTc=:rV-CAMgGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1=he�rerycaffirm under penalty of perjury one of the following declarations: v 5 nave and Snnl'i' 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 the 5(F� �.,r:lance of the work for, which this permit is issued. Policy No. s `lrcl a`va and wiV. ma,intairr,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' compensatiot `nsurance carri r,anG pplicy number are: er Policy Number Expiration Date e of Agent " i� Phone # :ertify that, in the 'performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers if I should become sub to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. compensation laws of California, and ag ignature of Applicant Date 'ECLARATION REG DIN— ONTSTRUCTION LENDING AGENCY hereby affirm 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). enders Name Lender's Address y my signature below!,:[ certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to t the abov, entified property for inspection purposes. ignature of Property Owner or Authorized Agent ( a �,�� Print Property Owner's or Authorized Agent's Name �� , �i 6�rit C '1 J*b 4A ; Date 9 it . 71 s i 1 DATE BY DECLARATION OF COd 4PLIANCE MTN CODE OF FEDERAL :REGULA TIONS PART 61 OF T17LE40 AA0 A%1i DRULE 140a ❑ f Sf#BMITTEt?AS STOS NO77F1CATIO TLC: ❑ EPA ❑ AQMD ❑ ASBESTOS N0711=1CARONtS NOT APPLICABLE TO €'ROPOSED DEMOLITION. SIGNATURE., FOR OFFICE USE ONLY PEfi¢PWTE PI=RED PERPATT CANCELLED EI�Tt iTT E? DE PELaWIT f INAL —ILg � 22., CE'i s 1FICATi E OF OCCUPAUCYISSUED