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Home My WebLink AboutE2015-0025 - PermitsCity of Newport Peaibh - Building Division 1111111111111111111111111111111111111111111111111111111 Jill 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 5 0 0 2 5 Permit Counter Phone (949)644-3288 Job Address: 20292 ORCHID ST Bldg: 1 Floor: Suite: Description of Work: ELEC/ NEW RECESSED LIGHTING IN KITCHEN (STND PLAN) Inspector Area: 3 Legal Description: N TR 1500 LO Owner: MCREYNOLDS CHRIST Address: 20292 ORCHID ST NEWPORT BEACH, CA Phone: Issued Date:01/1 Processed By: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or100oA: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $47.00 Electrical Permit: E2015-0025 Project No: Inspection Requests Phone (949)644-3255 1� ap�}llCCode OEdi: d fund 5 % Or © ()Tj-/a Cdd Receptacle/Switch/Outlets Race cle tl : $5 Fi ure B@".'6 7. S C' its. 0 Lo oltage (vy©rb St$U.00 Signs Branch Circuit: 0 $0.Q0___ 0 6 ensation Insurance n �I$@r's t0 Carrier: STATE COMP FUND °O°° Policy No: 9029249 ',r) Expire :07/20/2015_°��`o C tb 1 HP/KW/KVA: 'Q1 1 to 10 HP/KW/KVA: 0 10 to 50 HP/KW/KVA: 0 50 100 HP/ W/K_ : 0 Overer p(/iKVA: 0 Check Fee: $47.00 0 6 �v�{�rk started) $D.00 Temp Undergr $0.00 S_UhYa an Check Fee: 0 Investigation Fee: $0.00 Issuance Fee: Supplemental Fee: Fee Due at Permit Issuan PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION m mmeoc- • e c 0 ° ° o m o c me c mcoc c 000cr m000cc c om m $0.00° ° $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 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 ($500). 111, as owner of the property, or my employees with wages as their sole compensation, will do l_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale). 111, as owner of the property,: am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Rroperty Owner or Authorized Agent Date LICENSECMNTRACTOR'S DECLARATION Og$by affirry under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my li is in full force and@ffect. •••••• License Class ` License No Da Contractor Signal WORKERS;COMPENSATION DECLARATION ARNING: FAIlURE4O6ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL.SUSJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE p§f OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affipA upQPr penalty 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 th armance oithe work for which this permit is issued. Policy No. I ave aITd9VRIRQaintain 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' compensatio nce carrier and polic number are:. vier s `: � Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance of the work for wh' 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 become subject to the ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� 1iDaite� ts_— Signature of App' a DECLARATION RIEGARDWSiOEINSTRUCTION LENDING A Y 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: 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 ordinances and state laws relating to building construction. I authorize representatives of this city or count to enter thea ove-identified property for inspection purposes. A it Signature of Property Owner or Authorized AgenPrint Property Owner's or Authorized Agent's Nam z Dat ACTION DATE DECLARATION OF COMPLIANCE 141T CODE OF fOR OfRCEUSEONIY FEDERAL REGULA TIONS PART fit OF TITLE 40AND AQMDR7LE1403 Q 1 SUBWTTEDASBESTOS AmAF1CAT(ON TO: PERM/TEXPIRED. - PERMITCANCEILED Q EPA ❑ AOMD Q ASBESTOS NOTITTCATIONIS NOT APPLICABLE TO PERMIT EXTENDED PERMIT FINAL PROPOSED DEMOLITION. SIGNATURE. CER77FICATE OF OCCUPANCYi5 UED