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Home My WebLink AboutE2017-0510 - PermitsCity of Newport Beach - Building Division off. 4 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 216 AGATE AVE Bldg: 1 Floor: Suite: Description of Work: ELECTRICAL - R G (X2016-3788) -r'P P Inspector Area: 2 Legal Description: BALBOA ISLAND RESUB SEC 1 BILK 10 LOT 33 Owner: HILLMAN KAREN Contractor: Address: 20 BRENA Address: IRVINE CA 92620 Phone: Phone: $0.00 Con State Lic: Issued Date:10/03/2017 Lic Expire: Service Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0 $0.00 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or1000A: 0 $0.00 0/H to U/G 0 $0.00 TOTAL Fee: III II II IVIII VIII VIII III III�I lllll'lll 1 u110 II JOSH LINDSAY BUILDERS 9092 ENLOE WAY GARDEN GROVE CA 92844 714-271-4565 1002027 03/31/2019 BT30057219 11/30/2017 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs • ° e ° °once Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 i° Electrical Permit: E2017"05TO 0 Project No: 1686-2016 .'•..•°°^" Motors/Transformers (HP/KVA) 0 ^ e Inspection Requests Phone (949)644-3255, ° • • e , °° oeo• ^ e°c , • ° e ° °once e � 0 $0.00 eecrr 0 $0.00 Over 100 HP/KW/KVA: ^ ° 11"7_71 Issuance Fee: $33.00 Code Edit: 2016 4 `7 V eee 6 C11 d €_.� Worker's Compensation Insurance Carrier: EXEMPT Policy No: Expire : FEES 0 $0.00 Motors/Transformers (HP/KVA) 0 $0.00 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 BackfTemp Power: 1 $36.00 Temp Power Pole: 0 $0.00 Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $33.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. oe ,e ••OWNER-L3UU-pERDECLARATION • I herebyqVfh under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) �• ($ection 703.5, 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 tTie 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 �o8e) 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 Rot more tl dh flee hundred dollars ($500). • ❑ I, as oweer 4 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, • 8usiness•&d8131rofessions 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 „ irpprovements 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 • improved for thepurpose of sale). .wnero ® I, 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 eno woBr of property who builds or improves. thereon, and. who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 131 amrsxempt 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 Profess!�deTBIYd� licensjay a is in full force and effect.-2 ffect.� pi7' y � g License Class License No Da 11 Contractor Si nature 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 ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th performance of the work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatioi rance carrier and policy number are: ier Policy Number Expiration Date is of Agent Phone # rtify that, in the performance)ythe work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre If I should become subject rf f(a workers' co enzat or rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.. ature of Applicant Date C�^' ., ..,.r,..., .,�,..rr..,. I hereby affirm under pep6lty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ord' antes and state laws relating to building construction. I authorize representatives of this city or cou t toe r the above -identified property for inspection purposes. k$' Signature of Property Owner or Authorized Agent .di � Print Property Owner's or Authorized Agent's Nampf \ , Date rl/ �— AC77ON DATE RY DECLARATION OF COMPLtANCEMTH CODEOF le FOR DFFICE USE ONLY FEDERAL REGULATIONS PART 67 OF TITLE40AND AQMDRULE 1403. PERMIT EXP/R€D ❑ 1 SUDMfTIED ASBESTOS U077FICATION TO: ❑ EPA ❑ AQMD PERMiTCANCELLEO P€RMITEXT€NDED ❑ ASBESTOS NOTIRCA77ONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITFINAL / ( CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: