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Home My WebLink AboutE2022-0368 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111lil111p11111111111p 11 o s 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 2 0 3 6 8 Permit Counter Phone (949)644-3288 T LLYII14� Job Address: 1940 TERESITA LN Bldg: 1 Floor: Suite: Description of Work: ELEC/SEPARATE CIRCUIT FOR ABOVE GROUND PREFABRICATED SPA W/ASTMF1346-92 COVER Inspector Area: 3 Legal Description: N TR 1806 LOT 49 Owner: CONN ROBERT & PT Contractor: Address: 1940 TERESITA LN Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lie: Issued Date:06/17/2022 Lie Expire: Bus Lie: Processed By: Lie Exp Date: SHEAR CONSTRUCTION 31 BLAKEMORE DR LADERA RANCH CA 92694 714-615.6108 760853 07/31/2022 BT30049686 01/31/2023 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 1 $7.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Fee: Electrical Permit: E2022-0368 Project No : 2488-2019 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: OHIO SECURITY Policy No: XWS61231341 Expire : 04/1112023 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 Fee : z pr qi J 0 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 Ise PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday- Friday 7;00 am. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. )AINER-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 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 U all of or U 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 legally 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 fallowing 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 Pr f n Code,ha license is in full force nd effect. JC License Class License No D a(% FZ'L. Contractor Signature VORKERS' COMPENSATION DECLARATION �l 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 OST 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 thr erfjrmance of the work for which this permit is issued. Policy No. have and maI fain 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' rance ca Ier and olicy number aree: \ _ Date Name of Agent eS/ M 4V - � J_ %/ T Phone # ►r- ❑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 to become subject to the workers' compensation laws of California, and agre that, if I should become su sect to workers\c ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.Signature of Applicant V Date 1( C9 C j I `Z Z DECLARATION RE R ONSTRUCTION L DING AGENCY X I hereby affirm under penalty of perjurythat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cade). 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. ��l i I authorize representatives of this city or coupUto ter v I-ide ti d pro or ins ection purposes. ll Z Z Signature of Property Owner or Authorized Agents X_1� Print Property Owner's or Authorized Agent's Name X lCK��S D ACTION DATE BY DECLARATION OF COMPLIANCE AI TN CODE OF FOR OFFICE USE ONLY ,'DERAL REGJL:ITIONS-PART 51 OF TITLE 40 AND AOMD RULE 140 i. PERMIT EXPdRED 7 I SURm1ITT6) 458ES T+)S NC,TIFICATION TO:. ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS N07IRCA7ION IS NOT APPLICABLE TO PROPOSED DEMOLI T ION. PERMIT FINAL CERTIFi CATEOF SIGNATURE, OCCUPANCYISSUED