HomeMy WebLinkAboutE2021-0400 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
c� 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 4 0 0
Permit Counter Phone (949)644-3288
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Job Address: 74 LINDA ISLE Bldg: 1 Floor: Suite:
Description of Work: ELEC -PIGGY BACK METER
Inspector Area:
Legal Description:
2
N TR 4003 LOT 74
Owner: MUMMAJULIE
Contractor:
Address: 513 DRAGON GATE CT
Address:
HENDERSON NV 89012
Phone: 559-269-1500
Phone:
Con State Lic:
Issued Date:07106/2021
Lic Expire:
Bus Lic:
Processed By: i
Lic Exp Date:
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
Over 600V or 1000A:
0
$0.00
O/H to U/G
0
$0.00
RDMSINC
250 E BAKER ST # 300
COSTA MESA CA 92626
714-448-9835
815872
12/3112022
BT30008726
01/31/2022
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
Electrical Permit: E2021-0400
Project No : 0280-2021
Inspection Requests Phone (949)644-3255
Code Edit: 2019 -
Worker's Compensation Insurance
Carrier: EVERSTREMIER INS CO
Policy No: 7600015443191
Expire : 09/0112021 ,
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: 1 $41.00
Temp Power Pole: 0 $0.00
Plan Check Fee :
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
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.
)WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forthe 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
is 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
'rofessions 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
of 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,
lusiness 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
nprovements 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
nproved for the purpose of sale).
1 1, 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
ppiy to an oivnnr of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
,y 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
ell a structure tl lot 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
'rofessions Ccda, Is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
signature of Pcoper'y Owner or Authorized Agent Date
.�GENSED i3OMTRACTOR'S DECLARATION
;,Lreby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencin wit Section 7000) of Division 3 of the Business a Professions Code, and my license is in full force
rc' cf ect.
icens= Class _ License No Date T /y� Contractor Signatur
VCRI:ERS' COMPENSATION DECLARATION
't PN'NG: FAILU;tL'. r. SE.:URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU oRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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
eyformance 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'
carrier and policy number are:
Policy Number
Date
is of Agent Phone #
certify that, in the pert rmance 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
if I should become *bject tom wo>r s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prm&j6ns., � _ I
of
CLARATION RE RD" CONSTRUCTION LENDING AGENCY /
Ireby affirm under enalty perjury that there is a construction lending agency for the performance of the work for which this permit is issue (S tion 3097, Civil Code).
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 co my ordinances and state laws relating to building construction.
I authorize representatives of this city or cou o enter the abo den ified property for inspection purposes.
nature of Property Owner or Authorized Agen �� Print Property Owner's or Authorized Agent's Nam
AC77ON
DATE
RY
DECLARATION OF COMPLIANCE INIT!-1 CODE OF IFOR
FEDERAL REGULATIONS PART 51 OF TIRE 40 AND
AQMDRULE 1403.
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:.
❑ EPA
❑ AQMD
IS NOT APPLICABLE TO
ASBPERMIT
❑ POSED DEMOLOS ITION.
PROPOSED DEMOLITION.
SIGNATURE:
OFFICE USE ONLY
PERMIT EXPIRED
PERMITCANCELLED
PERA41 rTEXTENDED
FINAL
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%16 � M
CERTVFICATE OF
OCCUPANCYISSUED