HomeMy WebLinkAboutE2019-0497 - Permits (2)City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
' Permit CoBmitr riDone (949)644-3288
Job Address: 2415 NOVIA Bldg`. 1 Floor..
Description of Work:. ELEC/BBQ & FIRE -PIT
Suite:
Inspector Area: 8
Legal Description: N TR 7052 LOT 7
Owner: WOLFF JEFF Contractor:
Address: 2415 NOVIA PL Address:
NEWPORT BEACH, CA 92660
OWNER/BLDR
WOLFF JEFF
Phone: 562-577-1662 Phone:
Con State Lic: O/B
Issued Date:07/19/2019 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
New Construction
0
$0.00
Residential
0
$0.00
Multi -Family:
0
$0.00
1-2 Family:
0
$0.00
Service
0
$0.00
0-600V up to 20OA:
0
$0.00
0-600V over20OA:
0
$0.00
Over 600V or 1 OOOA:
0
$0.00
O/H to U/G
0
$0.00
TOTAL Fee: $37.00
Receptacle/Switch/Outlets
Receptacles/Outlets: 2 $2.00
Fixtures:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Signs
Policy No:
$0.00
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee :
$0.00
EIIT019�II�IIIII0 4I7 II
Electrical Permit: E2019-0497
Project No: 2440-2018
Inspection Requests Phone (949)644-3255
Code Edit: 2016
0
$0.00
1 to 10 HP/KW/KVA:
0
M
Worker's Compensation Insurance '
Carrier:
"
$0.00
50 to 100 HP/KW/KVA:
Policy No:
$0.00
Expire :
0
$0.00
X
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 Back/Temp Power:
0
$0.00
Temp Power Pole:
0
$0.00
Plan Check Fee :
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:
$35.00
Supplemental Fee:
$0.00
Fee Due at Permit Issuance :
$37.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7.:00 a.m. to 6. 0 p.m.•grdd yS.aturday from 8:00 a.m. to 6:00 p.m.
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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 place!# 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 issfance, 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).
❑ 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,
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
jipprovements 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
i � d for the purpose of sale).
I, Si 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
a 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 p�rermit, I cannot legall)
sell a structure that I have built as an owner -builder if' has not been construct d in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 044 oft B BUSin �s and
Professions Code, is available upon request whe a I' Ion' ted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Da
LICENSED CONTRACTOR'S DECLARATI N
I hereby affirm under penalty of perjury that
I am lice sed and r provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions ode, and,4y liter a is in full force
and effect.
License Class Licen Date - Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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
performance of the work for which this permit is issued. Policy No.
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' compensatiol
trance carrier and policy number are:
Tier - Policy Number Expiration Date
e of Agent Phone #
certify that, in the performance wor f whi this p rmit is issued, I shall not employ any person in any manner so as to become subject to the worker ca211 715
nsation laws of California, and agre
fi Lshould become' u Ct wo rs' n a rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr vi tons.
nature of Applica Da
CLARATION R A IN O_ UCTION LE N ENCY
:reby affirm under p natty of 0, that there is a const u tion lending agency for the performance of the work for which this permit is issued (Section 3k, Civil ode).
Ider'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 I have provided is correct. e
I agree to comply with all applicable city and count rdin nd state laws relating to building construction. �q )
I authorize representatives of this city or county t n e ab dentified property for inspection purposes. p1 r[\ I I _ I [
nature of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's Na'm v V v D
ACTION DATE BY DECLARATION OFCOMP[IANCEWITHCODEOF FOR OFFICE USE ONLY
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