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HomeMy WebLinkAboutE2021-0020 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1207 BERKSHIRE LN Bldg: 1 Floor: Suite: Description of Work: ELEC TO BBQ/FIREPLACE. Inspector Area: 3 Legal Description: N TR 3031 LOT 16 Owner: LARKIN Contractor: Compensation Insurance Address: 1 BE HIRE LN Address: AEWPORT BEACH. CA 92660 Phone: Issued New Constructiot� Residential 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 or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIII'I II Electrical Permit: E2021-0020 E 2 0 2 1 0 0 2 0 Project No: 0066-2021 BLUE PACIFIC POOLS SOUTHERN CALIFORNIA 25108 MARGURITE PKWY #A79 MISSION VIEJO CA 92679 949-310-3196 923454 10/31/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 3 $5.25 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 Motors/Transformers (HP/KVA) Inspection Requests Phone (949)644-3255 Code Edit: 2019 Carrier: STATE COMP INS FUND Policy No: 9126143 Expire : 02/28/2021 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: memm e m mmoe e Worker's omemme m 0 c ° oeoo 0 0� eo o mo , ° ° • 000c: 00 o e • oo°°c °o 0 oe000c � o 0000°r e 0000r 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: $37.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday- Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Lawfor the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any-structure, prior to it$, 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 L) 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 im roved for the purpose of sale). 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 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). ❑ 1 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 legall7 sell a struch"Waj 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. §LgDalure ofProperty Owner or Authorized Agent Date • LICENSEt 00WRACTOR'S DECLARATION . I hereby affimyunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) f Division 3 of the Business and Profesj%lal s��°o��e y license is in full force and effect. a p�/ Li Gense Class • License No Date ( X IZ ( Contractor Signature` OhKERS.CQJNPENSATION DECLARATION ✓ $V#9NING: FARURE TO%ECURE 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 COSPOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. W r affirm tinder penalty of perjury one of the following declarations: • . 12, ve and vdll•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 p lfp ance Mhe work for which this permit is issued. Policy No. a nA WIII•Atintain 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 ns ce carrier and policy number are: Ore Policy Number Expiration Date me of Agent In Phone # I certify that, in the performan of e k forwrl5eih IN mit is issued, I shall not employ any person in any manner so as to become subject io the workers' compensation laws of California, and agre t, if I should become sub' o t rkers' pen on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions mature of Applicant Date r7r 4-/- CLARATION REGARD NG CO LENDING AGENCY �reby affirm under penal edury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 propert owner's behalf. I have read this application and the information I have vI d is orrec I agree to comply with all applicable city and county o divan and ws Ing to building construction. I authorize representatives of this city or county to r I. bone tifi r -inspection purposes./ ,.atom n1 Prnnad., nwn nr Aulhnrlead An.1 Print PrnnrrrFv nurner'a nr Au}hnri7ed Ancnt'a Mnma ACTION DATE BY DECLARATION OF COMPLANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULA TIONS PART 61 OF T17LE40AND AQMD RULE 1403. PERMITEXPIAED ❑ I SUBMITTEOASEESTOS NORFICAFION TO. ❑ EPA ❑ AQMD PERMIT CANCELLED PERMfTEXTENDED ❑ ASBESTOS NORACATTONIS NGTAPPLICABLETO PROPOSEDDEMOUTIOPL PERMIT FINAL (. 2 vl, (( CERTIFICATEOF OCCUPANCYISSUED SIGNATURE.