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Home My WebLink AboutE2022-0020 - Permits04"1 City of Newport Beach - Building Division "E2022-0020' 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Electrical Permit: E2022-0020 Project No: Inspection Requests Phone (949)6%4-3.256 . J Job Address: 121 44TH ST Bldg: 1 Floor: Suite: Description of Work: MFR ELEC FOR (2) A/C UNITS AND (1) RELOCATED ATTIC FURNACE(LIGHT; OUTLET; & SWITCH). [H2O22-0023] Inspector Area: 1 Legal Description: RIVER SECTION BLK 44 LOT 22 Owner: MILNE ROBERT D Contractor: Address: 2432 GREENS AVE Address: HENDERSON,NV Phone: 7024569777 Phone: Con State Lie: Issued Date:02/15/2022 Lie Expire: � 's jw Bus Lic: 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 over20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $62.50 YES R & M INC 11131 ESSEX DRIVE LOS ALAMITOS, CA 90720 949.673-4455 829377 06/30/2022 BT30054750 04/30/2022 Rece ptac I e/Switch/Outlets Receptacles/Outlets: 1 $1.75 Fixtures: 1 $1.75 Sep Circuits: 3 $21.00 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 Code Edit: 2019 O : Z Worker's Compensation Insurance ffl Carrier: STATE FARM FIRE & UAL1'1' Policy No:92J1H7640F m Expire : 10/0312022 m m z Z z C. 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 at Permit Issuance : $62.50 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 items) 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 to 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 'rofessi,ns Codef o, teat 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 dl mo,e than five, hurd.ed dollars ($500). 1 1, as owner of toe p,operty, 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, ,us,ness 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 np•overt for the purpose of sale). I, as owner of fhe oroperty, 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 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 legally ell a stucture :hat' hove 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 '.CLEs'.ons Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.htm], I'gonture of P,operfy 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force effect. is (, I S " Z icense Class License No Date Contractor Signature PORKERS' COMPENSATION DECLARATION FARNING: 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 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 erformance 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' ranee carrier and policy number are: IS of Agent certify that, in the pf if I should become Iature of Applicant Policy Number Date the work for which 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 ,workers' fpmpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions/ Date /� 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 o eD�,t/E the ove-identifi roperty for inspection purposes. Signature of Property Owner or Authorized Agent �S Print Property Owner's or Authorized Agent's Name �1 V I �r I �r�'� 7 ate L' ` ACTION DATE By DECLARATION OFCOMPLIANCE MTHCOOE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 01 OF TITL.E40AND AQMD RULE 1403, PERMfT EXPfRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ElAQMO PERMIT CANCELLED PERMIT EXTENDED - ❑ ASBESTOS M077FICA77ON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED SIGNATURE:.