HomeMy WebLinkAboutE2018-0770 - PermitsCity of Newport Beach - Building Division
4 �2✓ 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 3 ROCKY POINT RD Bldg: 1 Floor:
Description of Work: ELEC/TEMP POWER POLE
Inspector Area: 4
Legal Description: P BK 95 PG 30 PAR 1
Owner: MAYYEE�EORGE
Address: 3 ROCKY POIIIQ RD
CORONA DEL IVj(�R CA 92625
Phone: 714-612-6903
Issued Ihpte:1113012018
Processed
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 over 20OA:
0
$0.00
Over600V or1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL
Suite:
Contractor:
Address:
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
Illliiiiiiiigiiii III Ploject No IE2018-0770
2588-2018
Inspection Requests Phone (949)644-3255
Code Edit: 2016 5 �,;
OWNER/BLDR Worker's Compensation Insurance
Carrier :
Policy No:
Expire
OIB
Receptacle/Switch/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
Plan
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: 1 $38.00
Fee :
Temp Underground:
Sub Panel:
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
Due at
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.
0 $n.90
$u.09
0 $0.00
0 $0.00
$0.00
$0.00
$0.00
$35.00
$0.00
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) Inc
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, der
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sect
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sale compensation, will do L) all of or U portions of I
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com{
rim roved for the purpose of sale).
ff I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractol
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one t
sell a structure that I have built as an owner -builder if i tag, not en constructed in its entirety by licensed contractors. I un
Professions Code, is available upon request whe t rap submitted e¢�at the foljdwing Web site:http://www.legin
Signature of Property Owner or Authorized Agent ��f bra `/%a-`i`�/L�
LICENSED CONTRACTOR'S DECLARATI>� �;/7—�
I hereby affirm urder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) o
and effect.
License; Class _ License No Date
WORKERS' CUM PENSATION DECLARATION
NAPNI913; FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL'
'DST')' COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
F.=reby affirm i'i penalty of perjury one of the following declarations:
J I nave and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
:ed�: r.tance oli wor'; for which this permit is issued. Policy No.
-it have and will ,maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the pe
ist, c.e carrier and policy number are:
ad below by the checkmark(s) I have placed next to the applicable tterni
Ih, or repair any structure, prior to its issuance, also requires the applicant for
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
work, and the structure is not intended or offered for sale (Section 7044,
ployees' or personal effort, builds or improves the property, provided that the
ion, the Owner -Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
that a copy of the applicable law, Section
/,
and
Division 3 of the Business and Professions Code, and my license is in full force
Contractor Signature
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Policy Number Expiration Date
Agent Phone #
y that, ir: tha- 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
hould becomesubject to the worke . compensation prQv, ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
a
of
=reby affirm undell penalty of perjury that there is a construction lending agency for the performance of the work for which
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 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 to ente above-iden ' grope y inspection purposes.
4
nature of Property Owner or Authorized Agent,p _ for _ Print Property Owner's or Autl
ACDON I DATE I if BY
Mill
CLHTIFICATEOF
OCCUPANCY6SUED
FEDERAL REGULATIONS PART 61OF
AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS NOTIRC
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFiCATIONIS NOT
PROPOSED DEMOLITION.
SIGNATURE:
Date
permit is issued (Section 3097, Civil Code),
TO:
Name
TO