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HomeMy WebLinkAboutE2021-0871 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1732 CANDLESTICK LN Bldg: 1 Floor: Suite: Description of Work: ELEC -TEMP POWER POLE (X2021-3426) Inspector Area: 3 Legal Description: N TR 3763 LOT 33 Owner: CLARK FAMILY TRUST Contractor: Address: 1732 CANDLESTICK LN Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:12/21/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: 111111111111111111111p11111111�1111111111111p1111111 Electrical Permit: E2021-0871 E 2 e 2 1 8 8 7 1 Project No : 2999-2021 JENKINS CONSTRUCTION 168 MONTE VISTA AVE COSTA MESA, CA 92627 714-345-9371 901221 07/31/2023 BT30035239 04/30/2022 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: 0 $0.00 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 [a Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9076367 Expire : 10/20/2022 FEES �`f1 Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.�1i 1 to 10 HP/KW/KVA: 0000, 10 to 50 HP/KW/KVA: 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 $41.00 Check Fee: ss a 4Y 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 7:00 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 Iicensure 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 U all of or U 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). ff 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). ❑ I am exempt from Iicensure 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 legall. 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, Se ion 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.htm[. 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 Sec ion 70 0) of Division 3 of the Business and ro a ions od and y lice Is in full force and effect. License Class License No Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affi nder penalty of perjury one of the following declarations: . 1 ha 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 thl o e of the work for which this permit is issued. Policy No. 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 n.su nce carrier and policy number are: Tie of Agent certify that, in the p I, if I should become nature of Applicant _ 3reby affirm under penalty of perjury that therag a c ider's Name my signature below, I certify to each of the following I am the property owner or authorized to act on the I have read this application and the information I hE I agree to comply with all applicable city and coup I authorize representatives of this city or county t f nature of Propertv Owner or Authorized Agent s ACTION I DATE PERMIT FINAL CERT(F)CATEOF OCCUPANCYISSUED Policy Number RTA Date I;ion sued, I shall not employ any person iany manner so as to become subject tot workers' c nsation laws of California, and ogre lions I of Section 0 of the Labor Code, shall forthwith comply with those provisions. Date' agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Address to building construction. inspection purposes. Print Propertv Owner's or FEDERAL REGULATIONS PART 61 OF TITLE40A AQMD RUL E 1403. ❑ I SUBMITTED ASBEST NOPFICATIQN TO: ❑ APA D ❑ ASBE OSN FICA NISNOTAPPLICAI SON Date . , tOR OFFICE USE ONLY