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Home My WebLink AboutE2021-0752 - Permitsw„g City of Newport Beach - Building Division -, 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 r v Job Address: 5 LEESBURY CT Bldg: 1 Floor: Suite: Description of Work: DELTA 5 ADD OUTLETS AND FIXTURES (X2020-2766) Inspector Area: 4 Legal Description: TRACT NO 11605 LOTS 7 AND 8 POR OF LOT 8 Owner: ROBERTS LUKE Contractor: Address: 5 LEESBURY CT Address: NEWPORT BEACH, CA 9 0 Phone: Phone: Con State Lie: Issued Date:11/01/2021 Lie Expire: Bus Lie: Processed By: Lie Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over 20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: MICHAEL ROBERTS HOME BUILDER INC 6 CALLE ALIMAR RANCHO SANTA MARG CA 92688 949-858-7540 681116 09/30/2023 BT30060668 09/30/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 30 $45.00 Fixtures: 80 $95.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Electrical Permit: E2021-0752 Project No: 2199-2020 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: FALLS LAKE FIRE Policy No: MIWC255788 Expire : 0112412022 FEES 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: 0 $0.00 Check Fee : rOD ' a 4„W 4a • • • • • •• goo-• '• • 404 Temp Underground: 0. $0a00 Sub Panel: 0 $0 nq 9••P0• $ft.pn•, 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $121.80 Investigation Fee: $0.00 Issuance Fee: $0.00 Supplemental Fee: $12.00 Fee Due at 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. LDER 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 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 U 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). 111, 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 LICENSED CONTRACTOR'S DECLARATION I 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 and Professions Code, and my li�ense is in full force and effect. • • ��n A �/ (�O-'�/ License Class ••�. License No 6�%)� Date��, q-112/ Contractor Signature V.QlkKERS'-CO*M 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 ATTORNEYS FEES. llre ky affirm. pQgr penalty of perjury one of the following declarations: �'+ I -gave and.wiii4aintain 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 Pe ante of•the work for which this permit is issued. Policy No. ...... 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' compensatior insurance carrierand policy number are: ev-1g. Policy Number Expiration Date Name of Agent • • Phone # ®I certify that,ipttasperformance of the work forwhich 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 tFial,`i?l should become • subiget to the workers mpggggn ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Signature of Applicant/r`�'� Date DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby 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). 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 have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to tt jr the ab a- ntified property for inspection purposes. Signature of Property Owner or Authorized Agent Tf/ Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFRCE USE ONLY FEDERAL REGULATIONSPART 61 OF TI7LE 40AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTEDASBESTOS N071F/CATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTEAIDED ❑ ASBESTOS N07IRCA770NIS NOTAPPLICABLETO PROPOSEDDEMOUTION. PERMITFINAL C QPY- CERTrFICATE OF SIGNATURE. OCCUPANCYISSUED