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Home My WebLink AboutE2022-0299 - Permitswr•„ City of Newport Beach - Building Division 0'1 �L� 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 nr [irnYHi� Job Address: 1115 ESSEX LN Bldg: 1 Floor: Suite: Description of Work: ELEC -BBQ Inspector Area: 3 Legal Description: N TR 3000 LOT 43 Owner: LAUER MATT & ANDREA Contractor: Address: 1115 ESSEX LN Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:05/11/2022 Lic Expire: 9 Bus Lic: Processed By: Lic Exp Date: Y� 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 over20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $41.50 IIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2022-0299 E 2 0 2 2 0 2 9 9 Project No : 0126-2021 WEST HILLS MASONRY 18195 MCDURMOTT E STE B IRVINE CA 92614 714-519-5009 920870 09/30/2022 BT30072553 0713112022 Receptacle/Switch/Outlets Receptacles/Outlets: 2 $3.50 Fixtures: 0 $0.00 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 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: SERVICE AMERICAN INDEMNITY CO Policy No: SAAWC000064700 Expire : 08/01/2022 i 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 Plan Check Fee : 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: $38.00 Supplemental Fee: $0.00 Fee Due 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. " " IWNER-BUILDER 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 dem(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 is 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 'rofessions 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 of 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved 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' State License Law does not pply 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). I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 Iegall ell 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 applicab w, action 7044 of the Business and rofessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) of Division 3 of the Business nd Profe ons Cod , a license is in full force is effect. icd� ZL 9 ense Class License No D L � Contractor Si natu PORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL S 11100,0001, IN ADDITION TO THE DST OF COMPENSATION, 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: I 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 the e ormance of the work for which this permit is issued. Policy No. 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' carder and policy numb / I Pnlicv DfNmhcr Expiration Date _ lame of Agent rnone ff 11 certify that, in the pert Tram; of the for which t p rmit 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 rat, if I should become bject the w rs' mpen o provisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions. I S Y/ ZZ ignature of Applic n a L IECLARATION RE RDI G CONSTRUCTION LENDIN GENCY hereby affirm under penalty of perjury that there is a constr ction lending agency for the performance of the work for which this permit is issued (Se ion 3097, Civil Code). ender's Name ender's Address Iy my signature below, I Certify to each of the following: I am the property owner or authorized to act on th roperty ow s b half. I have read this application and the information I ave provided i Co act. I agree to comply with all applicable city and ce my ordinance n state la relating to building construction. I authorize representatives of this city or coun to enter the ab a dentified property for inspection purposes.Lj��signature of Property Owner or Authorized Agent Print Propert Owner's or Authorized Agent's Name ate \ FOR OFFICE USE ONLY ACTION DATE BY DECLARAFION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIGIvS PART 610e= TILE 4.7 AND ) AQMD.ZU:..E 140. PERMIT EXPIRED ❑ ISUBMI'7EBASR-ST05 NO IFICAFION %0: ❑ EPA" ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO PROPOSED 06Mr_7LITION. SIGNATURE: PERMITCANCELLED PERMITEXTENDED PERMIT FINAL i CERTIFICATEOF OCCUPANCYISSUED