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HomeMy WebLinkAboutE2018-0805 - Permitsw City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 y Permit Counter Phone (949)644-3288 V ` rt���e��wfr Job Address: 9 BAY ISLAND Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE Inspector Area: 1 Legal Description: S TWP 6 RGE 10 SEC 34 Owner: MARTIN BRIAN Contractor: Address: 26021 ATLANTIC OCEAN DR Address: LAKE FOREST CA 92630 Phone: Phone: Con State Lic: Issued Date:12/20/2018 Lic Expire: Bus Lic: Processed 13 . �. 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 200A: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V orIOOOA: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: LEGACY CUSTOM HOMES INC 1000 QUAIL ST, STE 220 NEWPORT BEACH CA 92660 949-887-4750 986194 08/31/2019 BT30045036 10/31/2019 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs 0 $0.00 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Electrical Permit: E2018-0805 Project No : 2387-2018 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: OAK RIVER INSURANCE Policy No: LEWC912262 O° Expire : 12/02/2019 ° . . o 0 0© eoao e .eco 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 Backfremp Power: 0 $0.00 Temp Power Pole: 1 $38.00 Plan Check Fee: Temp Underground Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: 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 D OOODOO B ° . . DD . o.DDOC o c EOeDC D eDDco CGODCC D D o c 0.�000C 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 VNER-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) otion 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 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 Ifessions 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 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, siness 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 rovements 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 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 Ay 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: 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 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 ifessions.f:Gde. is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Wture of Property Owner or Authorized Agent Date 2ENSEQCQNTRACTOR'S DECLARATION ;reby affirlH'under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 )theusiness and Profes 'orfs Code, a my li r�Sa is in full force leffect.nse Class .. License No at '� — Contore )RKER94eb JIPENSATION DECLARATION rNING: FAILBR9T0 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 q OF COMFY %AII 03N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. :reby affirm nder penalty of perjury one of the following declarations: IbFk ve 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 thI inandbi f%.; cork for which this permit is issued. Policy No. and wilMmaintain 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' cainei and policy number are: is of Agent certify that, in the performance of , if I sho idled become subject tqfl�q Of Policy Number Expiration Date work for which this permitis is�sued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and "kers' co_mpereation prgli;k 5ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /4 /Zo%n ECLARALAM-REGARBff rCONSTRUCTIOERDING AGENCY hereby affirm under penalty of perjury that t1hard Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address y 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 ordina s and st s relati o building construction. — ------/-- 1 authorize representatives of this city or county to ent a at ent ied p1ppeffty for inspection purposes. of Property Owner or Authorized A en Print Property Owner's or Authorized Agent's Name .E ACTION DATE' BY DECLARATIONOFCOMPLIANCEMT CODEOF FOR OFFICE FEDERAL REGULATIONS PART 61 OF TITLE40AND TEXPIRED AQUO RULE 1403. 0 I SUBriOTTEDASBESTOST07IFICATIONTO: TCA.NCELL€D 0 EPA T€BTENDED 0 AQMD [3 ASBESTOS N017FTCA TFINAL I—L41_.I'o l P OPOSEODEMOLITION.UONlSNOTAPPLfCA81.ETO OCCUPANCYISSUED I I I SIGNATURE: