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HomeMy WebLinkAboutE2018-0523 - PermitsnW City of NqwportBea°ci5�©u1ling Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Electrical Permit: E2018-0523 o . : 100 Civic Cellist Drive, Neu�7poi°cgeaa ,, CA,9 '60 E 2 e 1 8 m 5 2 3 Project No: 1870-2018 Ha ,� Permit Counter Phone (949)644-3281 Inspection Requests Phone (949)644-3255 0 Job Address: 1012 BAY AVE W Bldg: 1 Floor: Suite: Description of Work: ELEC -TEMP POWER POLE (X2018-2359) Inspector Area: 1 0 $0.00 Code Edit: 2016 Residential Legal Description: N TR 626 BILK 5 LOT 8 0 to 1 HP/KW/KVA: Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 Owner: KABERNA KEVIN Contractor: PATTERSON CONSTRUCTION WorkerItN'� hperrs tion )hsi�rande Address: 1012 BAY AVE W Address: 15 CORPORATE PLAZA STE.150 CarT �E�COMP NEWPORT BEACH, CA 92661 Service NEWPORT BEACH CA 92660 Poli 466 Supplemental Fee: Phone: Phone: 949-723-1800 Expire :08/01/2018 Branch Circuit: 0 Con State Lie: 802367 0 $0.00 Issued Date: Lie Expire: 07/31/2020 Over 600V orIOOOA: 0 $0.00 Time Clocks: Bus Lie: BT02110534 O/H to U/G 0 Processed By: 4ZIA Additional Fee: Lie Exp Date: 09/30/2018 New Construction 0 $0.00 Receptacle/Switch/Outlets Residential 0 0 to 1 HP/KW/KVA: 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 $0.00 Investigation Fee: Low Voltage 0 $0.00 Service $33.00 Signs Supplemental Fee: 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V orIOOOA: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 FEES 0 $0.00 Motors/Transformers (HP/KVA) Sub Panel: 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/K\/A: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Piggy BackfFemp Power: 0 $0.00 Temp Power Pole: 1 $36.00 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. )WNER-BUILDER DECLARATION : : 0 ; ; : . • �• ,;, I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by Wroheokmari I I•iave 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 he 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 Seclion 7000) of Division 3 of the Business 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 applitint fol;gpermitcuWedtlithe.applicant to a civil penalty of Lot more than five hundred dollars ($500). • ,' . • • , o a ; ; I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and th0 Auctorg is not intended or offdred for sale (Section 7044, 3usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or per3onal effort, builds or improves the property, provided that the mprovements 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 mproved for the purpose of sale). 7 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 Ipply 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). 1 am exempt from licensure under the Contractors' State License Law for the following reason: 3y 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.htmi. 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 Profs s ' ns de, and my license is in full force Ind effect. .icenseClass License No Date �Contractor Signature YORKERS' COMPENSATION DECLARATION IARNING: 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 ;OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: II 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 e rmance 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 Date Name of Agent Phone # 1:1I certify that, in the performance 0"'e 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 I should becorlr`la sybject to th ork ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. eR Signature of Applicar c Dat? ` 1 DECLARATION REGARERNG CONSTRUCTION LENDING AGENCY w I hereby affirm under penalty 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 provide 's correct. I agree to comply with all applicable city and county ordinanc andtate laws relating to building construction. I authorize representatives of this city or couenter th -i entified property for inspection purposes. (� p' Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Nal Date -71 0 AC770M DATE BY DECLARATION OF COMPLIANCE tMTH CODEOF FOR OFFICE USE ONLY FEDERAL REGULA77ONSPART &1 OFTITLE40AND AOMORULE1403. PERMIT EXPIRED 1 SUBMITTED ASBESTOS NOTIFICATION TO. ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT:EXTENDED i°OPOSEDDEASBESTOS Fd TION15 NOT AP1JGCi4BLE TO MOU PERMITF1NAL 10-3 ^ '� S CERTIFICATEOF - DCCUPANCYtSSUED SfGNAT pg