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Home My WebLink AboutE2024-0104 - Permits4�EwPoRT City of Newport Beach p dcn Community Development Department- Building Division ' > 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic IIII IIIIIIIIIIIIIIIIIIIIIIIIIII4 II Electrical Permit Plan Check No : PC2023-0617 Work Class : Other Issued Date : 02/22/2024 Final Date: Permit Status: Issued Inspection Area : 4 E2024-0104 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 2433 BLACKTHORN ST Legal Desc : N TR 4893 BLK LOT 83 Description: ELEC - AC DISCONNECT (H2O24-0101) Owner: ARTHUR JAMES MOSER Address : 2433 BLACKTHORN ST NEWPORT BEACH, CA 92660 Phone : (412) 334-6717 Applicant: BEN MEDINA Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone : (818) 735-7876 Owner/Builder : Address Phone: Code Edition : Type of Construction Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone : X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: 44% Contractor : HG HOME SERVICES Address : 1501 WESTCLIFF DR NEWPORT BEACH, CA 92660 Phone : (949) 877-2821 Con State Lie : 1077757 Lie Expire : 07/31/2025 Bus Lie : BT300768818 Bus Lie Expire:02/28/2024 Workers' Compensation Insurance Carrier : CLEAR SPRING PROP R CASUALTY CO Policy No : CWC00016801 W. C. Expire: 6/16/2024 Fire Hazard Zone : NO Occupancy Groups : a I hereby affirm underpenally of perjury that 1 am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7Q31.5, Business and Professions Code: Any city or county that requires a permit to coris"Ct, 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 from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicantto a civil penalty of not more than five hundred dollars ($500). I, as owner of the property,or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professions Code: the Contractors' Slats License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property,, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or 0Improved for the purpose of sale). I, as owner of the properly, am exclusively contracting with licensed Contractors to construct the project (Section 7944, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). El I arm exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) sell a structure that I have built as an owner -builder if it has not boonconstructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application Is submitted or at the following Web site:http:llwww.leginfo.ce.gov/calaw,html.. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) I 3 of ihe$pstness and. Pxo s Code.. and my license is In full force and effect. License Class License No Date ' Contractor Sit WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ON. HOUSAND DOLLARS ISID0,00a1, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37H OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 0 I have 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 In performance of the work for which this permit is issued. Policy No., rreyui Jtava 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' compensatior l l anee carrier and policy number are: Policy Number of Agent Date 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' if I should become subject to the wswkars' compensation provisons of Section 3700 of the Labor Code,. I shall forthwith comply with those provisions. hereby affirm under to of that there is a construction lending agencyfor the performance of the work for which this permit is issued'. (Section 3097, Civil Code), Hinders Name Lender's Address y my signature Diiii certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read thisapplication and the information I have provided is correct. I agree to comply with all applicable city and county ordi2,attJoesi state la I authorize representatives of this city or county to eakerthe above-i Iec r�,rleflrfg to building construction. property forfnspection purposes. ACTION DATE B ON OF COMPLIANCE WITH CODE OF FEDERAL LATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 PERMITEXPIRED _ _ `CLAR " _ i tI �SU'RM:TTEO ASBESTOS NOTIFICATION TO __ v PERMITCANCELLED PERMiTEXTENDEO � LNONID PERMfT FINAL 09/II/Z`I D��ol-kK ASSES TO5 NOTIFICATION 15 Nor APPLICABLE TO CERT IFICATE Of PROPOSEDDEMOLITION OCCUPANCY ISSUED ; SIGNI.TCRE: FOR OFFICE USE ONLY of California., and