HomeMy WebLinkAboutEL060211_068t0000003ky5IAAQ_ELECTRICAL PERMITCounty of Orange
Resources & Development Management Department
Main Office
300 N. Flower Street
Third Floor
Santa Ana, CA
92702
Inspection Office
22921 Triton Way
Laguna Hills, CA
92653
For Inspections Call: (714) 796-0407 or (949)472-7922 or Visit us on the web at: http://www.ocplanning.net
ELECTRICAL PERMIT
Building Permit Number: EL060211 Issue Date: 4/19/06
Description of Work/Use: temp power pole Issued By: John Powers
Work Authorized: PB:N ME:N EL:N Gas Meter: Elec Meter:1
Job Address: 22433 Pelicans Dr, Newport Coast Owner: Pridemark Gen. Contracting & Development
Additional Address: Address: 54 Tesla
Assessor Parcel No: 473-163-01 Irvine,CA 92618
Legal Description: 15346 5 TR Phone: 949-951-3434
Related Permits:
Contractor:S R Bray(Applicant)Architect:
Address: 1005 N. Edward Court Address:
Anaheim, CA 92806
Phone: 800-863-2525 Phone:
License#: 523596 Class: License#: Class:
By signing below, I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to
building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes.
Declarations: I hereby affirm under penalty of perjury that:
Licensed Contractor Declaration
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 and effect.
License Class: License No.: 523596
Contractor: S R Bray
Owner - Builder Declaration
I am exempt from the Contractors' State license Law for the following reason
(Sec. 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 there from 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 the work and the structure is not intended or offered for sale (Sec.
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 does
the work himself or herself or through his or her own employees, 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 he or she did not build or improve for the
purpose of sale.).
I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project (Sec.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 such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law).
I am exempt under Sec. , B & P.C. for this reason
Construction Lending Agency
I 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 (Sec.
3097, Civ. C.)
Lender's Name: None
Lender's Address: None
Workers Compensation Declaration
I have and will maintain a certificate of consent to self-insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain worker's 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' compensation insurance carrier and policy number are:
Carrier: American Home Assurance
Policy Number: WC1178790
I certify 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' compensation laws of California, and agree that, if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Warning: failure to secure workers' compensation coverage is unlawful, and shall
subject employer to criminal penalties and civil fines up to one hundred thousand
dollars ($100,000), in addition to the cost of compensation, damages as provided
for in section 3706 of the labor code, interest, and attorney's fees.