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Home My WebLink AboutE2018-0581 - Permits-qty•of 1+9wport Beach - Building Division 0100 div¢ic Cnnfrr Drive, Newport Beach, CA 92660 *Q&nnJt..ouBttp} Phone (949)644-3288 m m omc oe m o e o • m •o • • e •JobAddresV37" AVIGNON ' Bldg: 1 Floor: Suite: Description of Work: ELEC -1 SWITCH FOR SPA LIGHT Inspector Area: Legal Description: N TR 14571 LOT 29 Owner: SPOKOYNY FELIX Contractor: Address: 37 AVIGNON Address: NEWPORT COAST, CA 92657 0 to 1 HP/KW/KVA: Phone: Phone: 1 Con State Lie: Issued Date:08/29/2018 Lie Expire: $0.00 Bus Lie: Processed By: Lie Exp Date: II VIII IIIIIIIIIIIIII IIII IIIIIVIII IIIIIIIIII III II TREEIUM INC 5352 LAUREL CANYON BLVD #200 VALLEY VILLAGE CA 91607 855-833-8733 617148 04/30/2019 BT30053191 11/30/2018 New Construction Receptacle/Switch/Outlets Residential 0 to 1 HP/KW/KVA: 0 Receptacles/Outlets: 1 $1.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Electrical Permit: E2018-0581 Project No : 0204-2018 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: CAROLINA CASUALTY Policy No: BNUWC0144084 Expire : 05/18/2019 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: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Fee Due at Permit Issuance PERMITS EXPIRE 980 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. 1.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 OWNER -BUILDER DECLARATION ' ' ' e ' 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 placedTett to t* *ppc*Ie.ItEln(§S) e (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! else requires theepplioent fon e 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 applicant to a civil penalty of not more than five hundred dollars ($500). ,• • , „ .0. .0. e ❑ 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 o((dred f(Ir sale ftdtioV044,^ 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 theepperty!provide&that Mlee a 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 oiproving that it was no{built or im roved 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 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 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. 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Dat Zc/ id Contractor Signature NORKERS' COMPENSATION DECLARATION NARNING: 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 (5100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. here by affirm under penalty of perjury one of the following declarations: have andwill 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 th ante of the work for which this permit is issued. Policy No. �Ilh ve 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' compensatioi nsur ce carrier and policy number are: i ler ('G 9-O �i hC( CQ SUAi-,<`/ Policy Number )')NUWCoT 440d�/ Expiration Date r7� �8 RC1 Vame of Agent Phone # ❑1 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 Calif rnia, and agre .hat, if I should become subject to the workers' compen tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3ignature of Applicaf)y D �q )ECLARATION REGARDING CONSTRUCTION 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 (S tion 3097, Civil Code). (�- -ender's Name Lender's Address 3y 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 1 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 enter the above- fled property for inspection purposes. Ae3ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name/%/IJi 1 10 25-61()d Date dY_?R'L AC77ON DATE BY DECLARATION OFCOMPLIANCEiMTNCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART Of OF TITLE40AIVD AQMDRULEE 1403. PERMITEXPIREO I SUBMITTED ASBESTOS NOBFICATION TO.' ❑ EPA PERMITCANCELLED ❑ AQMD PERMIT EXTENDED ❑ ASBESTOS N017RCA17ONIS NOT APPLICABLE TO PROPOSEDDEMOLITION. PERMIMNAL ? ltg CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED