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Home My WebLink AboutE2019-0828 - PermitsQ ,�r,HrIY)4, City of Newport Beach - Building Division pa 100 Civic Center Drive, Newport Beach, CA 92660 F : ,•;�} -) n Permit Counter Phone (949)644-3288 » f'�ii➢,IL%y} Job Address: 409 MORNING STAR LN Bldg: 1 Floor: Suite: Description of Work: ELEC/OUTLETS AT DOCK Inspector Area: 3 Legal Description: N TR 4224 LOT 175 Owner: OMMID LLC Contractor: Ad ss: 3 7 S BRISTOL ST #271 Address: SA TA ANA, CA 92704 Phone: Con State Lic: 19 Lic Expire: Bus Lic: Lic Exp Date: New Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: II �IE III II� 0�I�I III �I�III 0�� I�� II�� II SWIFT SLIP DOCK/PIER BUILDERS 6351 INDUSTRY WAY WESTMINSTER CA 92683 949-631-3121 797052 07/31/2021 BT01122734 11/30/2020 Receptac lelSwitch/Outlets Receptacles/Outlets: 4 $4.00 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 Electrical Permit: E2019-0828 Project No : Inspection Requests Phone (949)644-3255 INN 9- T®rg Code Edit: 2016� 1 Worker's Compensation Insurance Carrier: AMERICAN LONGSHOR Policy No: ALMA01662-01 Expire : 12/31/2019 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: Temp Underground: 0 Sub Panel: 0 0 Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental 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. $n.00 $o.nn , $o.nn $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 )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 items)t for 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 applican he 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 Irofessions 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 tot more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness 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 mprovements 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 mproved for the purpose of sale). ❑ 1, 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 Iicensure 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 year prior to completion of the improvements covered by this permit, I cannot legall) sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Date 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 Section 7000) of Division 3 of the Business an rof Ions Code, nd y license is In full force and effect. I 11( �) n License Class License No Date `�1" Contractor Signature �/ 1 VORKcRS' COMPFNSATION DECLARATION "ARNING. FAILUR'c TO cEGURE 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: ve and will ma',ntam 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 0" nce of the work for which this permit is issued. Policy No. I-tfav . and w-11 mglntain 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' compensation Irsur .ce carrier and policy number are: Policy Number Expiration Date yam„, 11 certify that, in tl,e perfor nce the work for w ' 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 agre tat, iI i should tie:�r'1 s ct to th o ers' m nsat' provisi ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant — IECLARATION REGA DING CONS RUC ON L AG CY hereby affirm under pe alty of perjury that there is a cons ction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address ly my signature below, I 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 co 1 agree to comply with all applicable city and county ances an state we relating to building construction. I authorize representatives of this cityor count t nter bo I property for inspection purposes. /ti(� /t ;ionature of Pro ertv Owner or Authorized Agent y�� Print Property Owners or Authorized Agent's te✓� y t 6' 1VI I 1 I ACTION I DATE PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSVED BY FEDERAL REGULATIONS PART 610. .. --- 40AND AQMD RULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION, SIGNATURE: OFFICE USE