HomeMy WebLinkAboutE2022-0861 - PermitsaEvvPo� City of Newport Beach IIII I I II I II I II III I II i I II Electrical Permit : E2022-0861
o� A Community Development Department- Building Division
> y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: 1007-2022
Permit Counter Phone: (949) 644-3288 - Work Class: Other
c r Inspection Requests Phone: (949) 644-3255 Issued Date : 11/16/2022
5�/iO0.N\ newportbeachca.gov/inspections
Inspection Area : 2
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 : 204 PEARL AVE
Description
Owner:
Address
Phone:
ELEC: INSTALL ELECTRICAL FOR BBQ
SHELLEY STARR
204 PEARL AVE NEWPORT BEACH, CA
Applicant:
SHELLEY STARR
Address:
204 PEARL AVE NEWPORT BEACH,
Phone:
(310)409-7577
Owner/Builder
: SHELLEY STARR
Address:
204 PEARL AVE NEWPORT BEACH,
Phone:
(310)409-7577
Code Edition : 2019
Type of Construction :
92662
Building Setbacks : Front: 6, Side: 3, Side: 3, Rear:
Flood Zone: X; AO 1
Use Zone: R-BI - Two -Unit Residential, Be
PROCESSED BY:
SPECIAL CONDITIONS: HIGH DENSITY ZONE
nd
Addre:
Phone
Con Si
SEC 1 ELK 8 LOT 26
e:
No:
Expire
azard Zone <P NO
Panty Groups : 0
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I hereby affirm under penalty of perjury that 1 am a
(Section 7031.5, Business and Professions Code: An
the permit to file a signed statement that he or she is
Professions Code) or that he or she is exempt from II(
not more than five hundred dollars.($S00).:
❑ I, as owner of the: property„ or my employees with
Business and Professions Code:: The Contramors'. $4
improvements are not: intended or offered for sale. If,
imp roved for the purpose of sale).
rBsell
as owner of the property,. am: exclusively. contra)
tc an owner of propertywho builds or improves
am exempt from licensure under the Contractorsy signature below I acknowledge that, except for
structure that I have built as an owner•bu)Ider f
to
+ever,. the building or improvement is sold within one year of cr
I with licensed Contractors to construct the project (Section 70
eon, _and who contracts for the pmjects with a licensed Contra
or
toitem(s)
applicant for
s Business and
Civil penalty of
State License Law does not
I nereoyathrm under penalty or perjury that.I am licensed under provisions-dFOhapter 9.(commencing :with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect. License Class License No; Date _ Contractor Signature
ORKERS' COMPENSATION DECLARATION
WARNING: FArLURETO SECURE wORNERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CR/MINAL PENALT6ES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001. IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 114 SECTION 37011 OF THE LASOR CODE, INTFREST, AND ATTORNEYS FEES.
(hereby affirm under penalty of perjury one of the following dociarahons
13 I have: and will maintain a certificate of consent to self insura for workers' compensation issued by the Director of In& strial Relations as provided for by Section 3700 of the Labor Code, forth,
performance of the work for which this permit is Issued Policy No
I have and will maintain workers' compensation Insurance, as required'. by Section 3700 of the Labor Code, for the periont once of the work for which this permit is issued.. My workers'-compensatior
insurance carrier and policy number: are:
Carrier Policy Number. Expiration Date
Name of Agent Phone #
I certify that, in thq pe ormance of the work for which this permit Is Issued, I shall not employ any person in any manner so. as to become subjected the workers' compensation laws of California, and agre+
that, if I should beco .object # - wor s s' compensa n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant _ . _,..... __ Defa _
DECLARATION RE DI G U "TION L ENCY I
I hereby affirm under Wally of perjury that CharO is nstruGlign tending ageneyfar Cite performance of the work for which thjspermit is issued (Section3097, ivii Godej..
Lender's Name t Pnriar'a Addr,?ee I_.
I gg)* Ae property owner or authorized to act on the property owners behalf,
• I have read thi:;ap{r 4tion and the information I It provided is correCL
• is agree to comply witl! all applicable city and ct n ordinances and state laws relating to building construction.
. 1 axrll5rtze repre`aehWtives of this city or county enter bov ratified pally fo inspection purposes.
Si wature of Pro ar or Authonzed Agent Print Prop 1, Agent's Narne V� 1, �-'t DaVI ( ae Z
ACTIOM- •••• DATE. BY OlKLARATION OF CO NCE WITH: CODE OF FEDERAL FOR OFFICE USE ONLY
•• ss • • REGULATIONS. PAAT:61 OFTITLEAOANDAQMD RULE
ramvnv'Al • • LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF •• 'S/� �� PROPOSED DEMOLITION
OCCUPANCY ISSUED 1 SIGNATURE: