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HomeMy WebLinkAboutE2021-0327 - Permits (4)wrr,� City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 I0enInit Counter Phone (949)644-3288 V ��fi4�3T Job Address: 1331 ANTIGUA WAY Bldg: 1 Floor: Suite: Description of Work: ELEC/BBQ AREA Inspector Area: Legal Description: N TR 3852 LOT 16 Owner: 1331 ANTIGUA NEWPORT BEACH LLC Contractor: Compensation Insurance Address: 1331 ANTIGUA WAY Address: WILLIAM YANG NEWPORT BEACH CA 92660 Phone: 949-395-5055 Phone: 949-395-5055 Con State Lie: O/B Issued Date:05/18/2021 Lie Expire: Bus Lie: Processed By: (' 1 / Lie Exp Date: New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 3 $5.25 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 200A: 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 Fee Electrical Permit: E2021-0327 Project No : 2315-2019 Inspection Requests Phone (949)644-3255 tZCA Code Edit: 2019 _ OWNER/BLDR Worker's Carrier : Policy No: Expire : 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 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: $37.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : 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. DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the mason(s) indicated below by the checkmark(s) I have placed next to the applicn1 o 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, priorto 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). 111, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portion 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, thro gh 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 I ompletion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section' apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Cont ❑ 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 sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractor, Professions Code, is available upon request when this application is submitted or at the following Web site:http://www Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION iI hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7C land effect. !License Class License No Date COMPENSATION DECLARATION Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). re year prior to completion of the improvements covered by this permit, I cannot I understand that a copy of the applicable law, Section 7044 of the Business and Date of Division 3 of the Business and Professions Code, and my license is in full force Contractor Signature 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 :OMPENSATION, 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: 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 3 mance 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' compensa rance carrier and policy number are: Policy Number IS of Agent certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall nature of Applicant CLARATION REGARDING CONSTRUCTION LENDING AGENCY veby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for 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 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 enter the above -identified property for inspection purposes. nature of Property Owner or Authorized Agent _ Print Property Owner's Date so as to become subject to the workers' compensation laws of California, and 1 comply with those provisions. Date this permit is issued (Section 3097, Civil Code). Date ACTION DATE BY DECLARATION OF COMPLIANC€MTH COKE OF FOROFIRCEUSEONLY FEDERAL REGULATIONSPART61 OFTIILE40AND AQMD RULE 1403. - PERMITEXPIRED ❑ 1 SUBMITTED ASBESTOS N07IFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED / ❑ ASBESTOS N07IRCA770MISNOTAPPL(CABLETO PROPOSED DEMOLITION PERMITFINAL . CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED