The URL can be used to link to this page

Home My WebLink AboutE2023-0503 - Permits��EWPO/7T City of Newport Beach p d Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic 111111111111111111111111111111111111111111111111111111Electrical Permit : E2023-0503 Plan Check No: Work Class : Other Issued Date : 06/0612023 Inspection Area :2 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 123 VIA ORVIETO Description : ELEC A/C DISCONNECT Owner: Johanna Staple Address : 2547 XANTHIA CT DENVER, CO 80238 Phone : (303) 525-5843 Applicant : DEPENDABLE GRAHAM AC Address : 2952 CENTURY PLACE COSTA MESA, CA 92626 Phone: (714) 546-1653 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction : Building Setbacks : Front: 0, Front: 4, Side: 4, Side: 4 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: L_.6� SPECIAL CONDITIONS: Legal Desc : N TR 907 BLK LOT 526 TR 907 LOT 526(AND NELY1/2 LOT 527 Contractor : DEPENDABLE GRAHAM AC Address : 2952 CENTURY PLACE COSTA MESA, CA 92626 Phone: (714) 546-1653 Con State Lic : 472690 Lic Expire : 04/30/2024 Bus Lic: BT01013104 Bus Lic Expire:12131/2023 Workers' Compensation Insurance Carrier : SERVICE AMERICAN INDEMNITY CO Policy No: SAMTWC0072801 W. C. Expire: 7/1/2023 Fire Hazard Zone : NO Occupancy Groups: U 3,w � 17 �� r, • OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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) etion 70315, 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 permit Io ffle 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 fassior s Code) or that he or she is exempt from licentiate 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 oI more than five hundred dollars ($500). 1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions. of the) lusiness and Professions Code: The Comractors' State License Law does not apply to on owner of property who, through emF nprovements are not intended or offered for sale. It, however, the building or improvement is sold within one year of completk n roved for the purpose of sale). I; as owner of the property, am Exclusively contracting With licensed Contractor$ to construct the project ($action 7044, Sul ly to an owner of property: who builds or Improves thereon, and who contracts for the projects with a licensed Contractor poi I am exempt from iicensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year all a structure that. I have built as an owner -builder if it has not been constructed In its entirety by licensed contractors, I under. 'rofessions Code, is available upon request when this application Is submitted or at the following Web site:h fp:/lwww,Ieginfo.c I?gnahtre of Properly Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commerioing with Sectio :nd effect. License Class License No Dat VORKERS' COMPENSATION DECLARATION k, and the structure is not intended or offered for sale (Section 7044, ees' or personal effort, builds or Improves the property, provided that the the Owner -Builder will have the burden of proving that It not built or and Profe$Sicns Coda: The Contractors' State License Law does not to the Contractors' State License law). applicable law, Section Date _ of the Business and Contractor Siena FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SNALL SUBJECT AN EMPLOYER TO CRUM PENALTIES AND CIVIL FINES UP TO OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF Tile LABOR CCDE, INTEREST, AND ATTORNEY'S FEES, hereby affirm under penalty of perjury one of the fallowing declarations: I I have and will maintain a certificate of consent to self -insure for workers' compensation, Issued by the Director of It rformance of the work for which this permit is issued. Policy No. ve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perk isurance carrier and policy number tire: ;arnar Policy Number. lame of Agent 71 certify that, In the performance of the work for which this permit is issued, t shall not employ any person In any manner so ienatu eshould beco a ubjec the p lion P rxm� Section 3700 of .the Labor Code,: I shall "with o ireby affirm under penalty of perjury that there is a construction tending agency for the performance of the work for which this ider's Name Lender's Address my signature below, 1 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 ounty ordinances and state laws relating to building cohehuetion I authorize representatives of this city or counzo a" the abovelIontified propeny for inspection purposes. By t DECLARATION OF COMPLIANCE WITH CODE OF FEDEI S REGULATIONS PART fit OF TITLE 40 AND AOMD RULE NOTIFICATION TO PERMIT EXTENDED LIAOMC _ PENMf7F)NAL \ ' - ASRE!'U"N,;,T, ATfGN I$ NJI APPLICABLE TO CEaTIflCAiE OF �(f'{ ` rnOR, "I�EMOLII ION OCCUPANCY ISSUED \�\\\"""rrr 1 sl.4WAT"RF1 of the Business and DOLLARS (;f 00,000), IN ADDITION Relations as provided for by Section 3700 of the Labor Code, for the work for which this permit is. Issued. My workers' Mom became subject to the workers' comperteatlon laws of California, and agre( Withthose provisions. Dort _ AIR: is issued (Section 3097, CIA Code). FOR OFFICE USE ONLY fA