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Home My WebLink AboutE2024-0119 - PermitsCity of Newport Beach o� Community Development Department- Building Division G 100 Civic Center Drive, Newport Beach, CA 92650 Permit Counter Phone: (949) 718-1888 C9<riOM1��P newportbeachca.gov/civic iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii II Electrical Permit Plan Check No : PC2022.3142 Work Class : Other Issued Date : 02/29/2024 Final Date: Permit Status: Issued Inspection Area : (y E2024-0119 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 516 ACACIA AVE Description : ELEC - PIGGY BACK Owner: BLAIR PORTEOUS Address : 601 4TH ST #129 SAN FRANCISCO, CA 94107 Phone : (415) 531-1880 Applicant: JON ROSS SOMICH Address : 601 4TH ST, # 129 SAN FRANCISCO, CA 94107 Phone : (775) 527-7527 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction Building Setbacks : Flood Zone: X Use Zone : PROCESSED BY: 9 Legal Desc : A TR CORONA DEL MAR BLK 529 LOT 18 CORONA DEL MAR Contractor : SAGE MODERN INC Address : 601 4TH, #129 SAN FRANCISCO, CA 94107 Phone : (775) 527-7527 Con State Lie : 983732 Lie Expire : 05/31/2025 Bus Lie: BT30071663 Bus Lie Expire:04/30/2024 Workers' Compensation Insurance Carrier: EVEREST PREMIER INS CO Policy No : 7600016252221 W. C. Expire: 3/15/2024 Fire Hazard Zone : NO Occupancy Groups : 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 items) ,,ection 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 Ic permit to file a signed statement that he or sho 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 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars- ($500). 3 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 License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovemenls 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 bui€t or nproved for the purpose of sale). 3 I,. as owner of the properly, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply 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). 7 I am exempt from licensure under the Contractors' Stale 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 legaly oil a structure that 1 have built asan owner -builder if it has not been constructod in its entirety by licensed contractors. I understand that a copy of the applicable law. Section 7044 of the Business and 'rofessions Code, is available upon request when this application Is submitted or at the following Web site:http:Ilwww,leg.info.ca.gov/calaw.html. signature of Property Owner or Authorized Agent ___.__T_�._ oat. ACENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that i am ifcensed under provisions of Chapter 9 (commencing with Section 70, 0) of @vision 3 of the Business and Pxgfes ' ns de, and my license is In full force no effect. License Class License No Date / ConUSol Signature VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORR.ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADDITION TO THE OST 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 I have and will maintain a certificate or 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 the ��oyr'formance of the work for which this permit is issued. Policy No, i l _ have 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' compensation isurance carrier and policy number are: Policy Number of Agent Date certify that, in the performance of 1Aork 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 agree if I should become sminksto the ork rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Of ECLARATION REGARDING CuJN5 I'RUCTION LENDING AGENCY DateF z 2 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 ender's Name Lender's Address ly 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 proi Is correct. I agree to comply with all applicable city and cut ty ordana ce d state laws relating to building construction. t authorize representatives of this city or county to ter {h v -identified property for inspection purposes. Civil Cade). ACTION DATE BY i DECLARAT€ON OF COMPLIANCE WITH CODE OF FEDERAL RFCULATONS PART 51 OF TITLE 40 AND ADMIT RULC 1403 FOR OFFICE USE ONLY PERMIT EXPIRED _ 7 I SUBMITTED ASBESTOS NOTIFICATION TO _____. ...... _- PERMITCANGELf: �D _ _.,.._.. ._.__—t-- __._....._.....__— ❑CPA PERMIT EXTEID[D _5 �_ AQMD _____ W PL+RMIT FINAL I_.I ASBESTOS NOTIFICATION I_y NOT APPLICABLE TO CERTfF1114TEOF PROPOSED DEMOLITION OCCUPANCY ISSUch SIGNATURE: