HomeMy WebLinkAboutE2021-0663 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 13 BEACON BAY Bldg: 1 Floor: Suite:
Description of Work: ELEC/TEMP. POWER POLE
Inspector Area: 2
Legal Description: R BK 9 PG 42 PAR 13
Owner: IRWIN NANCI Contractor:
Address: 19450 COUNTRY WOOD Address:
YORBA LINDA CA 92880
Phone: 714/743-4545 Phone:
Con State Lic:
Issued Date:10/04/2021 Lic Expire:
Bus Lic:
Processed By: `�� t Lic Exp Date:
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
TOTAL Fee : $79.00
11�111 111111111111111111111111111111111111111111111111 11Electrical Permit: E2021-0663
E 2 e 2 1 0 6 6 3 Project No : 2241-2021
LONGMAN CONSTRUCTION CO INC
2782 CIRCLE DR
NEWPORT BEACH CA 92663
949-722-7711
393881
08/31/2023
BT00001921
03/31/2022
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
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: STATE COMP INS FUND
Policy No: 9062475
Expire : 07/01/2022
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: 0 $0.00
Temp Power Pole: 1 $41.00
Plan Check Fee :
Temp Underground:
Sub Panel:
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
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.
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 (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State ,I,icgnse 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 owever, 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).
❑ L as owner of the property, am exclusively ontracting 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 proves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 am exempt from Iicensure under th ontractors' State License Law for the following reason:
By my signature below I acknowled at, 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 b ' n 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 Ie upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature roperty 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 00) ivision 3 of the Business and Professi s� and my license is in full force
and effect.
License Class License No Dat Contractor Signature,�C
WORKERS' COMPENSATION DECLARATION OF
WARNING: 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.
I 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 th
pejff tan_Qwof the work for which this permit is issued. Policy No.
and will rpaAR�in workers'npensation 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 a Doll v numb;,, -I ..
Date
of Agent
I certify that, in the performance oft e work for which thik permit is issued, I shall not employ any person in any manner so as to become subject to the workers' nsation laws of California, and agre
that, if I should become sub' the rkers' coon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions../�/
Signature of Applica^ECG
DECLARATION REr3ARD G CONSTRUC ON LENDING AGENCY or
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 provid 's core
I agree to comply with all applicable city and count ord' s a t s relating to building construction.
I authorize representatives of this city or county a -1 !fie roperty for inspection purposes.
Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Nam • D
ACTION
DATE
BY
DECLARATION OFCOMPLIANCE MTNCOOEOF
FOR OFFICE USE ONLY
TECEUL REGULATIONS PART 61 CF .'IRE 40 AND
A(IMD PULE 1410.
G I SllBMI FTED AS-3E TUS -VOTIFI(:ATION TO:
❑ EPA
❑ AOMO
PERMIT EXPIRED
PERMITCANCELLED
PERA41TEXTENDED
❑ ASBESTOS NOTIACARON IS NOT APPLICABLE TO
PROP03ED DEMOLITION,
PERMIT FINAL
CERTlF)CATE OF
SfG'VA TURc-
OCCUPA^1CYISS ED