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Home My WebLink AboutE2022-0185 - PermitsCity of Newport Beach - Building Division 1111111111111� p111111111111111111p11111p11111111111Electrical Permit: E2022-0185 100 Civic Center Drive, Newport Beach, CA 92660 E 2 9 2 2 e t 8 5 Project No : 0622-2022 (9) Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 504 ACACIA AVE Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE d Inspector Area: 5 Code Edit: 2019 1Y o d � Legal Description: CORONA DEL MAR BLK 529 LOT 6 Owner: TJC HOME BUILDER LLC Contractor: T J C HOME BUILDERS LLC Worker's Compensation Insurance Address: 26940 ALISO VIEJO PKWY STE 100 Address: 26880 ALISO VIEJO PKWY #100 Carrier: NATIONAL FIRE & MARINE INS CO ALISO VIEJO CA 92656 ALISO VIEJO, CA 92656 Policy No: 42HB615046601 Phone: 949-481-7026 Phone: (949)481-7026 Expire : 12131/2023 Con State Lic: 1025507 ' Issued Date:03/2312022 Lic Expire: 04/30/2023 1�us �5 Lic: BT30059037 Processed By: Lic Exp Date: 05/31/2022 ,> > New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 200A: 0 $0.00 0-600V over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 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 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 $41.00 Temp Underground: 0 Q0.00 Sub Panel: 0 °.C.00 0 $C.33 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 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 L) 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). 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 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 legallt 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 witSeIptlon 7 00) of Division 3 of the Business an Prof 'ons e, y license is in full force and effect. 2 License Class _ License No Date J Contractor Signatu %,ORKSRS' COMPENSATION DECLARATION WARNING: FAILURE Tn SFCVRE 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. I I.erety affirm under penalty of perjury one of the following declarations: -I. havF and will maiptain 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 th performance of the work for which this permit is issued. Policy No. and w" -nz'rtain 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' carrier and policy number are: me of Agent ` I (grtify that, ip she p t, if I should be"mee (nature of Applican4/_ Policy Number Date 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 Ile wOr rgI'�ompl n I rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio s. A T -2 � \1 I! U �I Date isVC ON L7ENDINqAGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 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 and the information I have provided is correct. I agree to comply with all applicable city and coup)y ordinances and ate laws relating to building construction. I authorize representatives of this city or cou t r ve= a ified property for inspection purposes. //�� -Z Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ' P(/ Dat`� ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TIRE 40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL Z,'L. CERTIFICATEOF SIGNATURE:. OCCUPANCYISSUED