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Home My WebLink AboutE2020-0237 - Permits1 r�r City of Newport Beach - Building Division IIIIu�II�III�IIIIIIII�III�IIINlllulllllllllPElectrical ject is l Permit: er it : E2020-0237 off. 100 Civic Center Drive, Newport Beach, CA 92660 - E 2 0 2 0 0 2 3 7 Permit Counter Phone (949)644-3288 �yL��4.kb' Inspection Requests Phone (949)644-3255 Job Address: 2701 CIRCLE DR Bldg: 1 Floor: Suite: Description of Work: ELEC -TEMP POWER POLE (X2020-1132) Inspector Area: 2 Code Edit: 2019 Legal Description: N TR 1102 LOT 27 PECTUK Owner: LISENBEE GARY Contractor: PATTERSON CONSTRUCTION Worker's Compensation In'144W Address: 2581 CIRCLE DR Address: 15 CORPORATE PLAZA STE.150 Carrier: STATE COMP NEWPORT BEACH CA 92663 NEWPORT BEACH CA 92660 Policy No: 9065406 Phone: Phone: 80236 3-1800 A "W 1,0bO810�y112020 � �®� Con State Lie: 802367 �11�% l� N� 9 tgt6aM p Issued Date:05/12/2020 Lie Expire: 07/31/2020 NOIs Bus Lie: BT02110534 C Processed By: -Lie Exp Date: 09/30/2020 pg ®N THE WEEKEND FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 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 0-6110V up to 20OA: 0 $0.00 Branch Circuit: 0 $0,00 Plan Check Fee: $0.00 0-600V over 20OA: 0 WOO Each Add Circuit: 0 $0.00 Piggy Back/iemp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1 OOOA: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $39.00 Issuance Fee: $35.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 TOTAL Fee: $74.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $74.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION GonstR<ction E'ac rsr. Mond y - l-riday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. e o 0 a Qo I hereby affirm under penalty of perjury that I am exempt Uomihe Contractors' Slate License Law for the reasorlts) Indicated below by the checkmark(s) I have placed next to the applicable Taints) !ction 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 permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing With Section 7000) of Division 3 of the Business and dessions 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 more than five hundred dollars ($500). I, as owner of the properly, or my employees with wages as their sole compensation, will do U all of or (_) portions of Ine work, and the structure is not intended or offered for sale (Section 7044, Aness and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who, through employees' or personal effort, builds or Improves the property, provided that the Uovements 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 itwas not built or noved 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' Slate License Law does not ]ly to an owner of property who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law). I am exempt from Ilcensure under the Contractors' State License Law for the follmving reason: 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 legalh I 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 ifesslons Code, is available upon request when this application Is submitted or at the following Web site:hrpYfw .leginfo.ca.gov/calaw.hlml. nature of Property Owner or Authorized Agent Date )ENSED CONTRACTOR'S DECLARATION areby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7001L Division 3 of the Business and Pmlessio Cotle, yiy license is in full force f effect. License Class License No Dat S/ r2/ 2e. Contractor Slgnatur2j( 7� )RKERS' COMPENSATION DECLARATION r N 1 U NG: 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 (F780.088), IN ADDITION TO WE "TOFCOMPENSATIO VAGES AS PROVIDED FOR IN SECTION Sre6 OF THE LABOR CODE INTEREST, ANDATTORNEYS FEES. ?reby affhm H ' Ity of perjury one of the lollmving declarations: I h _ IN�{1A1+ ' mtaln 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 for - a work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of Ilia Labor Code, for the performance of the work for which this permit is Issued. My workers' compensallo trance carver and policy number are: ne of Agent certify that, In the performance of the , if I should become subject to the VA Policy Number Date Nils pemlll Is Issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, and a0on provisions of Section 3700 of the Labor Code, I shall forthwith comply Will those provisions. 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 cedily to each of the following: I am the property owner or authorized to act on the property owners belief]. I have read this application and the Information I have provided Is correct. I agree to comply with all applicable city and county ordinances and s le laws relating to building construction. I authorize representatives of ids city or county toe he ab property for Inspection purposes. nature of Property Owner or AUINorized Agent i� Print Property Owner's or Authorized Aoenrs Nacre' I r ram+ DECCAUATION OF COMPLIANCE WITH CODE OF FEUD REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE EXPIRED I I I UtSUBMITTED crams rrTE I'OI I 7•A,/ IUgS8EEDD NOTIFICATION ISNOT APPLICABLE CERTIFIC4OCCUPANCYISF �F.. (1rr/tTul YBOYOSEU DEMOLITION OCCUPANCY ISSUED 7 I "W oaumnme.V OFFICE USE ONLY o n as � • • • • s � o n e tie • • • • s _ oar e • a ne - o00 00 • e o m m o 0 0 o a o a • o e• • e a 000 _n ss � • a• ••