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Home My WebLink AboutE2019-0125 - PermitsCity of Newport Beach - Building Division II�III�IIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 i Permit Counter Phone (949)644-3288 Job Address: 204 COLLINS AVE Bldg: 1 Floor: Suite: Description of Work: CHANGE OF CONTRACTOR/TEMP POWER POLE (REPLACES E2018-0024) Inspector Area: Legal Description: BALBOA ISLAND SEC 2 BLK 11 LOT 16 Owner: TRIMAR PROPERTIES Contractor: Address: 205 ONYX AVE STE B Address: NEWPORT BEACH, CA Phone: Phone: Con State Lic: Issued Date:03/05/2019 o m Lic Expire: Bus Lic: Processed By: Lic Exp Date: FERNANDEZ ROBERT CONSTR INC 923 EVERGREEN PLACE COSTA MESA CA 92627 949-981-9169 677390 04/30/2020 BT30046730 03/31/2019 Electrical Permit: E2019-0125 Project No : 0763-2017 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: W/C EXEMPT Policy No: (NO EMPLOYEES) Expire : m°mm mo.m e o o m •eeeoo Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) mo 00 ...... Residential m o m o e n 0 m. o mmem kob Multi -Family: ° m ° 0 $0.00 1 to 10 HP/KW/KVA: 0 om ° ° °me GAG. - .00e°1-2 1 -2Family: 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. rCCJ e omoeo New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) ...... Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: °°°°°a0 kob Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel 0 GAG. - .00e°1-2 1 -2Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 ° e o e m 'D0.00� ° Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00' 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Backrremp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 10o0A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 TOTAL Fee: $35.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $35.00 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) 1 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 (_) 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). 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 only 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: ly 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 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 Business and Professi s Code, anony license is in full force nd effect. .... icense Class ' License No Date Lq Contractor Signature �Q MIIRS' COMPENSATION DECLARATIONVU DARNING: FAILUR&T0 SECURE 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 OST 01 -COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 0708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm and eri nalty of perjury one of the following declarations: 5*I,have and wittanaintain 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 the 9rfoihfance of toe yvo&k for which this permit is issued. Policy No. '•••• • . I 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 isur ce carrier and policy number are: .•.••• erney . Policy Number Expiration Date qe ul that, ip ti>•e.pet* man �of the ork for which this ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' mpensation laws of California, and agree It, if I should beedrt'ie! subje the ers' ompen Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ^ )nature of Applicant Date iCLARATION REGA IN N UC LENDING AGENCY ereby affirm under penally perj that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). rider's Name Lender's Address 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 IAhavevidedt.I agree to comply with all applicable city and coue laws ing to building construction. I authorize representatives of this city or county led property for inspection purposes. ! " nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name to ACTION DATE DECLARATION OF COMPLIANCEWITNCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART Of OFTITLE40AND AQMD RULE 1403. ❑ I SUBMfTTEUASB€STOS NOTIFICATION T0:- ❑ EPA ❑ AQMD ❑ ASBESTOS N077FICA770NIS NOT APPLICABLE TO PROPOSEDDEMOl1TION. .PERMIT€XPIRED PERMITCANCELLED P€RMIT€XTENDED PERMITFINAL /J CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: