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HomeMy WebLinkAboutE2019-0612 - Permitsart, City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 H - Permit Counter Phone (949)644-3288 Job Address: 1839 SABRINA TER Bldg: 1 Floor: Suite: Description of Work: ELEC PIGGYBACK (X2017-3136) Inspector Area: Legal Description: N TR 2813 LOT 117 Owner: TUCKER R SCOTT/TUCKER K TR Contractor: Address: 1839 SABRINA TER Address: CORONA DEL MAR, CA 92625 Phone: Phone: Con State Lic: Issued Date:08/3 /2019 Lic Expire: Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over 600V or 1000A: 0 O/H to U/G 0 II IIS VIII 0IIII VIII VIII TVI VIII SII 1III III II RDMSINC 250 E BAKER ST # 300 COSTA MESA CA 92626 714-448-9835 815872 12/31/2020 BT30008726 01/31/2020 Electrical Permit: E2019-0612 Project No : 2183-2017 Inspection Requests Phone (949)644-3255 Code Edit: 2016 INSPECTOR Worker's Compensation Insurance Carrier: EVERST NATIONAL INS Policy No: 7600015443 Expire : 09/01/2019 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. e FEES 'JD4® •••° 0 o mango m e ao 0 ommm•o o m a o 0 os • $0.00 0 to 1 HP/KW/KVA: 0 m • s ° • o Fixtures: am m m m 0 $0.00 0 o n m o 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. FEES •••° 0 o mango Receptacle/Switch/Outlets Motors/Transformers(HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00' Temp Underground: •' 0 sm000 f9 m.. $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0•,® 0 P.00 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 m 0 N.M. Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00.00,P m $9.00. Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: ° ... $0.00 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Backrremp Power: 1 $39.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 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. )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 item(s) 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 applicant for is 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 'rofessions 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 of 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 l_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 n 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 doe-- only oesonly 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). ] I am exempt from licensure under the Contractors' State License Law for the following reason: lymy 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 legally ell 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 'rofessions 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 .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the ;ness and Pro ssions Code, a d my license is in full force nd effect. Zq icense Class License No 9�� J �— 1 1 Contractor ture VORKERS' CQMPENSATION DECLARATION 'QRNING: FAILURE T8 t961JRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE 0990FUOMPENSA5104 DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Aerebyaffinn underpenalty of perjury one of the following declarations: I tJAY� and will fnaintam 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 e rm�`nc of t14e � *.for which this permit is issued. Policy No. I a `and wiil 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 ,ne carrier.dhtI4l cy number are: •nUlpi. • "" Policy Number Expiration Date l�•SIwV,4Agent Phone # JI certify that, iA tft�gP'formance 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 agre( IignaFu eb Appiia'me .ubject to yh wo r ' compP�s ign.provisions of Section 3700 of the Labor Code, I shall forthwith comply with thosQ.pro 'sions. Dat IECLARAT R RDING"CO`/NSTRUCTION LENDING AGENCY -7-'-07 �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 issue action 309 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 aut naed,to act on the property owner's behalf. I have read this applicatio and the information I have provided is correct. I agree to comply with aj applicable city and county ordinances and state laws relating to building construction. I authorize representa0e�_#Tls city or county to e,YICe&Wh ove-F'�Intilted property for inspection purposes. .... .. ✓ D A� .. rbe, _ IQ AC77ON _—� DATE BY ULLLAKALtvrVUrwnrruxra4c VVIIrI VUrUr � tux urtlLt U37 y FEDERAL REGULATIONS PART 61OF TITLE40AND AQMO RULE 1403. PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERM(TCANCELLED P€RMIT€XTENDED ❑ ASBE-STOSNO77FTC4710MIS NOTAPPLICABLETO PROPOSEODEMOLITION. PERMITFINAL CERTIFICAT€OF SIGNATURE: OCCUPANCYISSUED