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HomeMy WebLinkAboutE2021-0409 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 '.% Permit Counter Phone (949)644-3288 Job Address: 221 SAPPHIRE AVE Bldg: 1 Floor: Suite: Description of Work: ELEC - TEMP POWER POLE Inspector Area Legal Description: BALBOA ISLAND SEC 3 BLK 9 LOT 27 Owner: SAILHOUSE Contractor: SAILHOUSE Address: 170 NEWPORT CTR DR #260 Address: 170 NEWPO NEWPORT BEACH, CA 92662 NEWPORT Phone: Phone: 949-281-6G Con State Lic: 1007 1 Issued Date:07/12/2021 Lic Expire: 09/33W21 Bus Lic: BT30036603 Processed By: r Lic Exp Date: 08/31/2021 111111111111111111111p1111111111111111111111111111111Electrical Permit: E2021-0409 E 2 0 2 1 0 4 0 9 Project No : 1208-2021 y5 C P )TER DRYt26py`� CA 92660, 5� Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: INSURANCE COMPANY OF THE WEST Policy No: WSD505264401 Expire : 12/29/2021 �tz tIm�-C T R FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HPIKVA) Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 100DA: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $41.00 Issuance Fee: $38.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 TOTAL Fee: $79.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $79.00 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. OWNER -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 the 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 not 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 improvements 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 improved 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 apply 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 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 year prior to completion of the improvements covered by this permit, I cannot legally sell 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 Professions 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 LICENSED CONTRACTOR'S DECLARATION I 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 and effect. ))) License Class License No D to %�«—�7-f Contractor SignViIV) COMPENSATION DECLARATION I/-7-- Vl DARNING: 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 IN orm ance of the work for which this permit is issued. Policy No. No.ave 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' compensatior Isur ce carrier and policy number are: of Agent Policy Number Expiration Date Phone # LJI 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 subject to the wwp�prs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Datt 7 DECLARATION REGA CONSTRUCTION LENDING AGENCY I hereby affirm under penalty o perjury that there is a construction lending agency for the performance of the work for which this permit is issued ( tion 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 andthe infonnation 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 eA�jt'er the Oove-identified property for inspection purposes. /� Signature of Property Owner or Authorized Agerjl�l /�/t*' Print Property Owners or Authorized Agent's Nan1eX (Jc� �> r0 wr1 Date 12 c ACTION RATE BY DECLARATION OF COMPLIANCE tMTN CODE OF V FOR OFFICE USE ONLY FEDERAL RFGULATIONS PART 51 OF TITLE40 AND A4MO RULE 1403. PERMIT EXPIRED ❑ I S::IBM'TTEDASBESTOS NCRFICATIONTO: [] 60A ❑ AQMD PERMIT CANCELLER PERA4tTEXTENDED ❑ ASBESTOS N077FICA77ON IS NOT APPLICABLE TO FF'OPOSED DEMOLITION, PERMIT FINAL i CERTIFICATEOF SI,3NAT RE:: OCCUPANCYISSUED