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Home My WebLink AboutE2021-0399 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2021 -0399 'f` r�3,e 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 3 9 9 Project No : 1517-2021 ,. ` v Permit Counter Phone (949)644-328,. - n sa. Q -�.��,��: Inspection Requests Phone (949)644-3255 Job Address: 1720 KINGS RD Bldg: 1 Floor: Suite: Description of Work: ELEC/TEMP POWER POLE Inspector Area: 7 Legal Description: Owner: WERNER ERIC Contractor: Address: 1720 KIN GS RD Address: NEWPORT BEACH CA 92663 ' Phone: Phone: Carrier: STATE COMP INS FUND Con State Lic: Issued Date:07/0612021 Lic Expire: Expire : 07/01/2022 Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 LONGMAN CONSTRUCTION CO INC 2782 CIRCLE DR NEWPORT BEACH CA 92663 949-722-7711 393881 08/31/2021 BT00001921 03/31/2022 r�1 Code Edit: 2019 �J FEES ' Worker's Compensation Insurance LU 0.p Carrier: STATE COMP INS FUND Policy No: 9062475 cJ Expire : 07/01/2022 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. °c ° o 0 0 • •o 0 0 . • • ° o • o • om° • • oc `o ocm • •° mco • c•m cc � •° m o co c o c m c FEES Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: .. 0 $0.00 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 $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 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $41.00 Issuance Fee: $38.00 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 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. °c ° o 0 0 • •o 0 0 . • • ° o • o • om° • • oc `o ocm • •° mco • c•m cc � •° m o co c o c m c 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 strdctMe, 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). ❑ 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 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). ❑ 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 legally 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.html. Signature of Property Owner or Authorized Agent Date ode 10. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect! 7000 Division 3 of the Business and Pro s Cod license is in full force and effect. License Class License No Dat6lj Contractor Signatu WORKERS' COMPENSATION DECLARATION WARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the work for which this permit is issued. Policy No. and will a tain workers' com�1 ensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier a p icy number a� j n _ Date lame of Agent Phone # DATE BY �I certify that, in the pertormance of ork for c Is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' co ensa laws of California, and agree lat, if I should become su ject t orkers' sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro visi ns. `- ••• • ignature of Applicant Date IECLARATION REGA G CONSTRUCTION DING AGENCY hereby affirm under penalty of perjury that the Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address y my signature below, I certify to each of the following: . • is be I am the property owner or authorized to act on thZprovi I have read this application and the information I hcor00,I agree to comply with all applicable city and counn aws relating to building construction. I authorize representatives of this city or county -1 tified property for inspection purposes. _ /y�w ignature of Property Owner or Authorized Agen_ Print Property Owner's or Authorized Agent's Name • 4M►b Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY ••• • FED RAL REGULATIONSPART 61 OF TITLE40 AND AQM !UL%1403. : PERMITEXPIRED : • .•. CI 4$UOM,CITjrD,49'BESTOS NOi7FICATIONTO: .� •SPA AQMD PERMIT CANCELLED . • PERMIT EXTENDED ❑ ASBESTOS N017RCA77ON IS NOT APPLICABLE TO PPOPO_JEDDF.MOLITION, ••• : • • • • • • • •• PERMITFINAL CERI(FiCATEOF • • OCCUPANCYISSUED • • • • SIaNIITOJjE:: • • • • • .