HomeMy WebLinkAboutE2022-0296 - Permits�a�,ckr City of Newport Beach - Building Division "E2022-0296'
p� p 100 Civic Center Drive, Newport Beach, CA 92660
s r Permit Counter Phone (949)644-3288 _
` a @�� z�PLECT0FI n a
Job Address: 2581 BAY SHORE DR Bldg: 0 Floor: Suite:
Description of Work: ELEC: (N) ELECTRICAL LINE FOR (E) BBQ & GARDEN
Inspector Area: 2
Legal Description: N TR 1102 LOT 15
Owner: WIESE GRANT & JI
Address: 2591 BAYSHORE yy�9aatQ,,�
NEWPORT BEACH, A 9210
Phone: 949-244-9036
Issued Date:05/09/2022
Processed By: 2-3
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
AL Fee : $45.00
Electrical Permit : E2022-0296
Inspection Requests Phone (949)644-3255
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Worker's Compensation Insurance
Ire I - Carrier:
R TTACHED Policy No:
;t9 - 44-9036 Expire: Noll,
�
O/B °
Expire:
Exp
Receptacles/O at $&06
Fixtures .0
NE3rch
1
lv(� $ 0.
Circuit:0
Add Circuit: 0.00CIrJSIFste• D $O.QO
0to1F
1to10
10to5
Check Fee :
too
PIKV �nI "
$0.00 p Underground:
Sub Panel:
$0.00
aai!VTemp Power: 0 $0.00
Power Pole: 0 $0.00
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
Fee Due at Permit Issuance:
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.
N
N
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$38.00
$0.00
INER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) i ad below by a checkmark(s) I have placed next to the applicable item(s)
ction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improv molish, or repair an structure, prior to its issuance, also requires the applicant for
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Sta tense Law (Chapter 9 (co encing with Section 7000) of Division 3 of the Business and
fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. An tion of Section 7031.5 by a Iicant for a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500). Qi�
I, as owner of the property, or my employees with wages as their sole compensation, will d all of or 10.mns of j�10y0�9kC and the struct a is not intended or offered for sale (Section 7044,
iness and Professions Code: The Contractors' State License Law does not apply to an er of prop o, thr 9% loyees' or pets I e rt, builds or improves the property, provided that the
rovements are not intended or offered for sale. If, however, the building or imp nt is so10; one year r�n mpletion, the O r-Builder II have the burden of proving that it was not built or
roved for the purpose of sale). \� �Io 0�
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the opZ(Section 7044, B essand Professions C e: The Contractors' State License Law does not
ly to an owner of property who builds or improves thereon, and wyl ontracts for th_e,projects wit licensed CoAFr pursuant to the Contractors' to License Law).
J I am exempt. from Iicensure under the Contractors' State
y my signature below I acknowledge that, except for my
ell a sthucture'he I hzve built as an owner -builder if.
s r
'rofessions Code, is available. upon request whe app is
'ig.latma of Property Owner or Authorized 't
.ICENSED CONTRACTOR'S DE T
hereby affirm ur.J3. penalty of p that I am I e n
Did eftect.
manse Class _ _ License
JJfchERSCO 9PENSI
ARNINU; FAILURE EFI'R
OST OF COMPENSATI GAM
hnre5 affirm under nail,
I' have and Mil�mal ail
erformance of the work
JI have and will maintain`
surance carrier and policy
:n I must have resld daet least one year prior to completion of t
its entirety`py lice s contractors. I understand that a copy of the
the following: site:http://w .leginfo.ca.gov/calaw.html.
of Chapter 9 (commencirtg`wi h^Section 7000) of Division 3 of the
Date Co SI
j16tttGRa COMPENSA N COVRAC IS UNLAWFUL AND SHALL SUBJECT AN.EMPLOYER TO CRIMINAL PEN- "AIIVIL F�)P TO
9S As PRO X 0FOR ECTI 3 OF THE LABOR CODE INTEREST, AND ATTORNEY's FEES. � � �A�V—
of p •'--` of th ng declar ioris \^J` ,.,( 5 4!'
a rtificate consent to self Are for workers' o pensation, iss by a D lctcr ctjMdustrial Relatio
rhi this s Issued--P,�ciillcy No. ` 0 t
orker mpens Insurance. as required by Section 3700 of the Labor Code, for the perform of t
limber are: ��4 ./1 -�4V'
Policy Number
Be of Agent r,
certify that, in the performance f the r which this
if I should become subject to th workers' co, pensati
nature of Applicant �'
ireby affirm under penalty of perjury thgitherdlp®ilstructi
ider's Name V vp
my signature below, I certify to each of th Oilowithng:
I am the property owner or authorized to a on e property
I have read this application and the informawoenerl—fte
Yi
I agree to comply with all applicable city anon
I authorize representatives of this city or co
of Property Owner or Authorized
Date
can
law, Section 7044 of the Business and
Code, and my license is in full force
($100,000), IN ADDITION TO THE
3700 of the Labor Code, for
this permit is issued. My workers'
)ecome s Iect to the workers' compensation laws of California, and
with those+ ?aKisions.
r Date
work for which this permit is issued (Section 3097, Civil Code).
Ts relating to building construction,
property for inspection purposes.
,1—P Print Property Owners or Authorized
ACTION
DATE
BY
DECLARATION' OF COMPLIANCE WITH CODE OF
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
AQMD RULE 1403.
❑ ( SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:.
FOR OFFICE USE ONLY
PERMIT EXPIRED
I 7 2
I/
PERMIT CANCELLED
PERMITEXTENDED
PERMIT FINAL
CERTIFFCATEOF
OCCUPANCYISSUED