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Home My WebLink AboutE2019-0684 - PermitsCity of Newport Beach - Building Division a; 100 Civic Center Drive, Newport Beach, CA 92660 H 1 Permit Counter Phone (949)644-3288 Job Address: 1129 PEMBROKE LN Bldg: 1 Floor: Suite: Description of Work: ELEC PANEL UPGRADE 125 AMPS Inspector Area: 3 Legal Description: N TR 3607 LOT 30 Owner: SCOTT RICHARD WARREN Address: 1129 PEMBROKE LN NEWPORT BEACH, CA 92660 Contractor: OWNER/BLDR Address: RICHARD SCOTT Phone: - Phone: Con State Lie: O/B Issued Date:10/09/2019 Lie Expire: Bus Lie: Processed By: � Lie Exp Date: New Construction • $0.00 Receptacle/Switch/Outlets Residential 0 to 1 HP/KW/KVA: 0 Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0,00 • • • 0 Low Voltage 0 $0.00 Service Worker's Compensation Insurance ••••• Signs •e•a • 0-600V up to 20OA: 1 $45.00 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 Fee ; II►iiii►iii►i►iii►i►i►iiii►iiipii►iii►ii►iii411 Electrical Permit: E2019-0684 Project No Inspection Requests Phone (949)644-3255 FEES • $0.00 Motors/Transformers (HP/KVA) 0 0 to 1 HP/KW/KVA: 0 • 1 to 10 HP/KW/KVA: Code Edit: 2016 $0.00 10 to 50 HP/KW/KVA: 0 •..mmo 50 to 100 HP/KW/KVA: 0 '�� • ��•• Over 100 HP/KW/KVA: 0 $0.00 •� 0 • • • 0 $0.00 •. o Fee Due at Permit Issuance: $00.00 Worker's Compensation Insurance ••••• •e•a • • n Carrier - Policy No: a .•• •••�� Expire: coomm ••.�� m 000mm•. o p m ommmom m •m • 0 0 o aooc comm FEES 0 $0.00 Motors/Transformers (HP/KVA) 0 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 $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: $35.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance: $00.00 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 le 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 BuNness 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 of more than five hundred dollars ($500). t.. 1 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, tusiness 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). I, as owner of the Woperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pp o an owrNT brorpperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors'. State License Law). I.arl exemptJrp"licensure under the Contractors' State License Law for the following reason: ly my s9gnatur6 pglpVh 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 all a structure that have built as an owner -builder if t has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7 A4 of the Business and 'rolassions Code,,% available upon request when t Is applica 'o is submitt r at the following Web site:http://www.leginfo.ca.gov/calaw.html. Ijgnatpre of PrpPdV(;wner or Authorized Agent Date .ICFQISED CONTRACTOR'S DECLARATION Dggrgby affirm u ndrr penalty of perjury that I am censed un er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cole, and my license is in full force nd enact. .... rMble Class License No Date Contractor Signature NkTkkRS' COMPENSATION DECLARATION ARNING FAILURE TS EE(�JRE 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 OWFUT-COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm ondereenalty 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 IN erformance of the work for which this permit is issued. Policy No. 71 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' compensatior isurance carrier and policy number are: Policy Number Expiration Date of Agent JI certify that, in the pe rmance 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 agree iat, if I should become ubject to the w' co nsat!on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision IignatureofApplicant Date 6C::�-d .Q.i Q LOl IECLARATION REGRDING CONSTRUCTION LENDING AGENCY hereby affirm under lanalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued ( ction 3097, Civil Code). ender's Name Lender's Address Iy 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 rdinances and, �t�elbVS relating to building construction. I authorize representatives of this city or county to th bove4 died property for inspection purposes. o ;ipnature of Property Owner or Authorized Apent Print Property Owner's or Authorized Agent's Name '1 Date ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODEOF FOR OFFICE USED LY FEDERAL REGULATIONS PART 61 OF TITL€40AND AOMDRULE 1403. PERMITEXPIRED ❑ I SUBMfTr€DASBE&TOS MJl7FICATION TO:. ❑ EPA E3 AQMD PERMrTCANCELIEO PERMIT€XTENDED ASBESTOS NOTIFI OOPOSEDDEMOLITIONTIONI5NOT APPLICA731.ETO PERMITFINAL ® CERTIFICATEOF SIGNATURE. OCCUPANCYISSOED