HomeMy WebLinkAboutE2022-0659 - Permits�gWPORT City of Newport Beach IIII I I II I II I it II II I I I I II
p� Community Development Department- Building Division Electrical Permit
> m y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
Permit Counter Phone: (949) 644-3288
u o- Inspection Requests Phone: (949) 644-3255 Work Class : Other
CqC/FOANGP newportbeachca.govCnspections Issued Datee: :
Inspection Area : 4
E2022-0659
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 1854 PORT KIMBERLY PL Legal Desc : N TR 7029 BLK LOT 30
Description: ELE- DISCONNECT FOR HEAT PUMP INSTALLATION
Owner:
Address
Phone:
LEWIS MALCOLM DAVID TR Contractor : JUST RIGHT SERVICES
1854 PORT KIMBERLY PL NEWPORT BEACH, CA92660 Address : 23482 PERALTA DR LAGUNA HILLS, CA 92653
Applicant: BEN MEDINA
Address: 31225 LA BAYA DR WESTLAKE
Phone: (818)735-7876
Owner/Builder :
Address
Phone:
Code Edition:
Type of Construction
Building Setbacks
Flood Zone:
Use Zone:
08
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i
nsurance
4ERICA INS CO
01 Cy o . 2VV Ii I V S
W. C.Expire: 7/15/2023
2019 Fire Hazard Zone < NO
Occupancy Groups: R3/U'
Front: 22, Side: 5, Side: 5, Rear:r10
X
PC - Harbor View Hills
PROCESSED BY:
SPECIAL CONDITIONS:
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Con State Lic
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GE, CA 91362 <. Bus Lic :
Bus Lic Expire
Workers'Corn
Carrier
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t hereby affirm under penalty of petlury that l am exempt from the Contractors' State License Lana for the reason(,$) indicated below by the
cfion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct. alter, Improve, demolish, or repair an.
next to the
_ ..
morethanlive hundred dollars'.($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the wqrk, and the structure is not. intended or offered for sale (Section 7044,
iness and Professions Code: The Cnntractors' 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
rovements are not intended or offered for sale.: If, however,. the building or improvement is sold within one year of txrmpletionl the Owner -Builder will have the burden of proving that It was not built or
roved for the purpose of salel.
1; as owner of the property, am exciusivaiy Contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Cods: The Contractors' State License Law does not
lyto 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 Lawj.
I am exempt from licensum under the Contractors' State License Law for the following reason:
Try signature below I acknowledge. that, exceptfor my personal residence in which I must have resided for at least one year prior to completion of improvements covered by this permit, I cannot lec
a structure that I have built as an owner -builder if it has not been constructed in f eehtirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
fessions Code, Is available upon request when this application Is submitted or at the: following Web site:http,.,/[ m.leginfo.ca:gov/calaw:htmi..
License
COMPENSATION DECLARATION
under. provisions of Chapter 9 (commencing with Be
License: No
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COV€RAGE. IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYERTO CRAMINAC PENALTIES AND CIVIL FINES UP TO ONE HUNPRED,fHOUaAND DOLLARS IS100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 94 SECTION Stirs OF THE I A13OR BODE, INTEREST. AND ATTPRNEY'S FEES:
I hereby affirm under penalty of perjury one of the following d0daratIMIK
kave: and will maintain a certificate of consent to self-insura for workers' compensation, issued by the Director:of Industrial Relations as provided for by Section 37GO:of the Labor Code, forth
mance of the work forwhich this permit is issued. PolicyNo,
ve and will maintain workers' compensation Insurance, as required by Section 37g0 of the Labor Code, for the' performance of the work for which this permit is issued. My workers' componsatio
-ce carrier and policy number are, ..
am r Policy Number Expiration Date
Name of Agent Phone. #
❑I certify that, in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as �O become subject to the workers` compensation laws of California, and agre
9 pP j Iy with those provisions. / r.
Signature ii � Dade/
that, if I should beco a sub ect vorkers' compensaiw ions oRSection 37DOof the Latter Coda, 1 shalt forthwith coin
DECLARATION S UCTION LENDING AGENCY
I hereby. affirm under pen jury that there is a Construction tendingageneyfor the petiormance:of the wdrk for which th€s. permh,isassued (Sectivn'3D07, 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 owners : behalf.
I have read this application and the information I have provided is Correct.
I agree to comply with all applicable city and county ordinan nd state laws relating to buildin construction..
I authorize representatives of this. city or county tQ enter e..above-9dantfned Inspection purposes.
ACTION DATE B: V R OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE. USE ONLY VJ
.CATIONS PART 61 OF TITLE 40 AND A4MD RULE
1403
PfRMI£fXPIREO Ui SUBMITTED ASBESTOS NOTIFICATION TO • • • :•" • ••• •••
PERMITCANCEtLEQ13EPA •• • •• °
PERMIT fX£ENOEO _ QMtJA O
PERMIT FINAL 2Z- /J,*/l/lJ ASBESTOS NOTIFICATION I5 NOT APPLICABLE TO
CERTIFVCATE OF ^�i PROPOSED DEMOLITION
OCCUPANCY ISSUED .SIGNATURE: • • • • • • • • e e
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