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HomeMy WebLinkAboutE2020-0256 - Permits9 of Center Beach achB gilding Division I II�I92660 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2020-0256 Permit Counter Phone (949)644-3288 Project No: 2387-2018 Inspection Requests Phone (949)644-3255 Job Address: 9 BAY ISLAND Bldg: 1 Floor: Suite: Description of Work: ELECTRICAL FOR BBQ Inspector Area: 1 Legal Description: S TWP 6 RGE 10 SEC 34 Code Edit: 2019 Owner: MARTIN BRIAN Contractor: LEGACY CUSTOM HOMES INC Worker's Compensation Insurance Address: 26021 ATLANTIC OCEAN DR Address: 1000 QUAIL ST, STE 220 Carrier: OAK RIVER INSURANCE LAKE FOREST CA 92630 NEWPORT BEACH CA 92660 Policy No: LEWC912262 Phone: Phone: 949-887-4750 Expire : 12/02/2020 Motors/Transformers (HP/KVA) Con State Lic: 986194 Issued Date:05/28 0 Lic Expire: 9 PEUIU 2 Bus Lic: BT3 0460 BT30045036 j Processed By: Lic Exp Date: 10/31/2020 $0.00 PERMITS EXP/RI Constry9fion HOursJ,Nonda8 - G G 6 C L o 4 6 G G O O O G 0Gc O f. OOG c 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. G e G 6 O 006 OC OOC O O OCO C < O G O O C ( G G GC G O C O O LO 000 O O 00 O4L 000 FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 2 $2.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 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 Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1 OOOA: 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: $37.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $37.00 PERMITS EXP/RI Constry9fion HOursJ,Nonda8 - G G 6 C L o 4 6 G G O O O G 0Gc O f. OOG c 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. G e G 6 O 006 OC OOC O O OCO C < O G O O C ( G G GC G O C O O LO 000 O O 00 O4L 000 OWNER -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 the 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 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 not more than five hundred dollars ($500). ❑ 1, 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, Business 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 improvements 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 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 apply 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). T I am exempt 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 legal) 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.htmi. 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 an�rofessi s Cade, and my tiis in full force and effect. License Class License No Da 2.3 'Z Contractor Signatur WORKERS' COMPENSATION DECLARATION MARNING: 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 (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: :11 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 the A111gfoEmance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Dale Name of Agent rnone e I certify that, in the performance 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 that, if 1 should become subject to the workers' com sation proves' s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant � -�' � Date DECLARATION RE I BN UCTION LEN NG AGENCY [�{� I hereby affirm under penalty of perjury that thereAf a construction lending agency for the performance of the work for which this permit is issued (Stion 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 ordinangs and state aws relating to building construction. I authorize representatives of this city or county to enW " abov id6Tr.. tified pro "for inspection purposes. Signature of Pro ert Owner or Authorized A ent Print Property Owner's or Authorized Agent's Nam fCLDate ACTION DATE BY DECLARATION OF COMPLIANCE MTR CODEOF FOR OFFICE USE ONLY ;�' FEDERAL REGULATIONS PART 61 QF JITFE•46AAD AQMO RULE ?403. PERMtTfxP1RED ❑ ISUBMITTED ASBESTOS NOTICICAT0WTO: , ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED 0 ASBESTOS PROPOSED DEMOLITCERTIJ BONIS NOT APPLICABLE �O . . •�• •• . . . . PERMITFINAL ^3p—jip IO.�. F SIGNATURE: OCCUPANCYISSOED •.• •• •. • • ••• ••