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Home My WebLink AboutE2021-0857 - Permits9 „ .r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2021-0857 a 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 a 5 7 E a p Project No : 2933-2021 w � " v Permit Counter Phone (949)644-3288 Arun• Inspection Requests Phone (949)644-3255 Job Address: 33 VERNON Bldg: 1 Floor: Suite: Description of Work: ELEC TO BBQ Inspector Area: 6 Code Edit: 2019 Legal Description: N TR 15333 LOT 5 Owner: SIDEBOTHAM ERIC Contractor: INSTANT POOLSCAPES Worker's Compensation Insurance Address: 33 VERNON Address: 833 DOVER DR #24 Carrier: WC EXEMPT NEWPORT COAST, CA 92657 NEWPORT BEACH CA 92663 Policy No: (NO EMPLOYEES) Phone: Phone: 949-795-0648 Expire Con State Lic: 1009644 Issued Date:12/15/2021 Lic Expire: 12/31/2021 Bus Lic: BT30053469 Processed By: C Lic Exp Date: 12/31/2021 FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 2 $3.50 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: 0 $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 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Backlremp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $38.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 TOTAL Fee : $41.50 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $41.50 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and SaturdaM (rode j3:00 am. I`q §:0012.1rb. c m o o ® € a m m o 0 o e o m o 00 0 o m e 00 o m mm o ® mo 0o moo o co 0 o O c ooc o °c c c c o o c c oc c. °c c c 0 o c o 0 0 o c om emo o m mm eo mom )WNER-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 ie 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 'rofessions Cade) 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 of more than five hundred dollars ($500). 3 I, as owner of the property, or my employees with wages as their sole compensation, will do `) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 n 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 pply 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 I am exempt from Iicensure under the Contractors' State License Law for the following reason: ly 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 ell 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 'rofessions Cade, 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 .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business license is in full force nd effect. \2 ' — i 1-icense Class License No Date Contractor Sig re VORKERS' COMPENSATION DECLARATION _r•,.. _._.__.,__..,_ 'ARNING: 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 DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under 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 the erformance of the work for which this permit is issued. Policy No. 11 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' compensation Isurance carrier and policy number are: 'tier Policy Number Expiration Date of Agent Phone # ce ify that, in the erformance of the wo for which 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 agree t, I should becom ubject t0 the worke action 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date CLARATION REGA NG T CTION GENCY :reby 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). 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 h prove creet'�� I agree to comply with all applicable city and c my o cesrdstate laws relating to building construction.I authorize representatives of this city or cou nter the aboentified property fo purposes. .-t \2 � Z1 nature of Pronertv Owner or Authorized AD / ® Print P pertv Owner's or Authorized Agent's Name �.1 t P� M W4- 1 Date ACTION BY RATIONOF COMPLIANCE tMTN CODE OF FOR OFFICE USE ONLY ,QA FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMDRULE 9403. PERMITEXPtRED . . . .. . , , .. •' • • • •' ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NONFICATIONIS NOTAPPLICABLETO PROPOSED DEMOUTLON. PERMIT CANCELLED • • • • • • PERMIT EXTENDED PERMITFINAL 3-.22-2 . . ,', ,', , , ; ;', CERTIFICATEOF ' ' • • • ' •„ '„ SIGNATURE:: OCCUPANCYISSUED ,�, �„ �,•