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HomeMy WebLinkAboutE2020-0126 - PermitsCity of Newport Beach - Building Division a 100 Civic Center Drive, Newport Beach, CA 92660 r.., �.,. Permit Counter Phone (949)644-3288 u e x ��xreixk"P Job Address: 4701 HAMPDEN RD Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE (X2020-0541) Inspector Area: Legal Description: N TR 3357 LOT 25 Owner: CHUNG YOON & SHINHYE Contractor: Address: 4701 HAMPDEN RD Address: . CORONA DEL MAR, CA 92625 Phone: 949-975-0123 Phone: Con State Lic: Issued Date:03/02/2020 Lic Expire: Bus Lic: Processed By: Lic Exp Date: IIIEIII IIIII0 IIIII0 �I�VI0 IIII�IIIII6 II MILO CONSTRUCTION 101 VIA MONTE PICAYO SAN CLEMENTE CA 92673 949-290-6429 871429 03131 /2020 BT30038762 03/31/2020 New Construction Receptacle/Switch/Outlets Residential 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 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: Electrical Permit: E2020-0126 Project No: 2225-2019 Inspection Requests Phone (949)644-3255 meem ° e• em Code Edit: 2016 eemm o� • ° m mee• • o 0 mo . �� e Worker's Compensation Insurance eeeomo • e. °°°°° Carrier: NO EMPLOYEES �•••°°° °°�° ° Policy No: m•• ° Expire: me °•°°°° 000c o ° .mem 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: 1 $39.00 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 Due at Permit Issuance : $74.00 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. 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 Iicensure 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 U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and ProlesUps 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 and i1c"ntended 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 iditl 81 for the -purpose of sale). 12 I, aF owner Beth@ property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not npfy t$9n 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 agn exempj frClflNicensure under the Contractors' State License Law for the following reason: Oy fnX' tgnature Below T 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 legall) sell a structure that I pave 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 PnolestLons Co%, j3 m1�ailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. StTiAtUre of Property 6wner or Authorized Agent Date [fq'ENFED COf1TRACTOR'S DECLARATION - 1 herebpaffirm enderbZnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business d Professions Code, and my license is in full force Bed exact. ' L Q%d#Class •••• License No Date Contractor Signat WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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. 131 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' compensatio, insurance carrier and policy number are: Carrier Policy Number Expiration Date ame of Agent Phone # I certify that, in the/DD11,NG ance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject t he workers' compensation laws of California, and agre the , f I should becomct to the workers' compensaationL.proovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi ons. Signature of ApplicanCu.0 p� L Da DECLARATION REGCONSTRUCTION LENDING AGE I hereby affirm underof perjury that there is a construction lending agency for the performance of the work for which this permit is issue (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 he provided is correct. 1 agree to comply with all applicable city and coun ordinances and state laws relating to building construction. I authorize representatives of this city or county t enter the above -identified prop rty for inspection purposes. 7 Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ��� -�— O , L Date.J • Z ACT70N DATE BY DECLARATION OF COMPLIANCE MTHCODEOF FOR OFFICE SE OIVtY 11 FEDERAL REGULATIONS PART Gf OF TITLE40 AND ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: PERMITCANCEltEO // ❑ EPA PERM(TEXTENDEO ij/� ❑ ASBESTOS NOTIFICATIONIS NOTAPPLICABL.E TO SIGNATURE: OCCUPANCYISSUED 1"