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Home My WebLink AboutE2021-0792 - PermitsIwo n� City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �'�4iJ+Vi4�1b Job Address: 1615 BAY AVE E Bldg: 1 Floor: Suite: Description of Work: ELEC/TEMP. POWER POLE Inspector Area: 1 111111111111111111111111111111111111111111111111111Jill Electrical Permit: E2021-0792 E 2 0 2 1 6 7 9 2 Project No : 2702-2021 Inspection Requests Phone (949)644-3255 NO CONSTRUCTION NOISE ON THE WEEKEND Code Edit: 2019 Legal Description: BALBOA BAY FRONT TR BLK P LOT 8 AND BALBOA TR EAST SIDE ADD BLK 25 FOR Owner: SCHULMAN JAY/NANCY Contractor: Address: 16201 MEADOWRIDGE WAY Address: ENCINO CA 91436 Phone: Phone: Con State Lic: Issued Date:11/17/2021 Lic Expire: Bus Lic: Processed By: Lic 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 PATTERSON CONSTRUCTION 15 CORPORATE PLAZA STE.150 NEWPORT BEACH CA 92660 949-723-1800 802367 07/31/2022 BT02110534 0913012022 Re c epta c l elSwitc h/Outlets Receptacles/Outlets: 0 $0.00 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 Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9065406 Expire : 08/0112022 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 BackrTemp Power: 0 $0.00 Temp Power Pole: 1 $41.00 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 : PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:C0 a.m. to 6:30`p.rrr. and Srturd:ty from 8:00 a.m. to 6:00 P.M. R-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 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, prior to its issuance, also requires the applicant for he 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 rot 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness 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 mprovements 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 mproved for the purpose of sale). 1, 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 Ipply 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). 1 am exempt from Iicensure under the Contractors' State License Law for the following reason: 3y 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 legall, ;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 applicable law, Section 7044 of the Business and )rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.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 7000) of Division 3 of the Business and Prof sions Cod , d my license is in full force Ind effect. �7 .icense Class License No Date ( / Contractor Signatur PORKERS' COMPENSATION DECLARATION 1ARNING: 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 I$100,0001, 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: 7 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 th 1,q4nance of the work for which this permit is issued. Policy No. 93"ave and will maintain workers' compensation insurance, as requireQ,by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior isurance carrier and pgAtT yumber are: / :arrier \l, ) _ _ I J B'Qlic y N r L . r eq k i _ Expiration Date ie of Agent certify that, in the performance of the work foNAich this permit is issul6d, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre t, if I should becomes )ect t e workers' co pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi 'ons. J nature of Applicant Da It / 1 % /% CLARATION REG DI TRU ION ENDING AGENCY ;reby affirm under penalty of perjury that there 9 a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 pr Ided is correct. I agree to comply with all applicable city and county ordi n nd state laws relating to building construction. I authorize representatives of this city or county tgente he ab property for inspection purposes. ACTION DATE 8Y DECLARATION OFCOMPUANCEMTN CODE OF _ FEDEFPL RCGULATIONSPART61 OF TITLE40AND AQMD RJLE 1403. ❑ IStBMIT7ED.1SBESTOSNO77FICATIONTO: _ ❑ EFA ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PRCPOSCD OE.XOL:T,`CN. SIGNATURE. FOR OFFICE USE ONLY PERMIT EXPIRED PERMIT CANCELLED PERMITEXTENDED PERMIT FINAL CERTIRCATEOF OCCUPANCYISSUED