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E2021-0375 - Permits
9 City of Newport Beach - Building Division Electrical Permit: E2021-0375 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 3 7 5 Project No : 1407-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 545 NEWPORT CENTER DR Bldg: 1 Floor: Suite: Description of Work: ELEC/LIGHTING FIXTURES (545 & 555 NCD) ^-rrN M 1407-2021 INSPEUIUM Inspector Area: 7 Legal Description: P BK 221 PQ,30!P , A , R 1 if applicable: Z d-L" Owner: IRVINE CO C=iactor'.--f��`EVA'10 INC ere r ;Rl= Address: 550 NE EN'I�t Address: 3621 SERPENJNEWI Mg R %E r D PROFESS OaC**-' 92 60 cy No: ON1004601 NE ORTBEA LO Poli Phone: 2'a PR q24,�3-71J%A! R ... ...... C " Siai* Q.`Lic to W -;�' �' .,-, Issued Date:O 122/2021 YZ �;. . xPir "Ak a Lic: BT30075660 Processed B Y: xp 2 NE EN�ORTBEA 6 122 D I W 6z 0 New Construction FEES Receptacle/SwitchlOutiets Motors/Transformers 514KVA) to 1 OH /K e ..... (Y $0!00� - I P P ri, 'Y I 4U 0110 u n d: 0 $0.00 01 1 "' tot Multi -Family: 0 $0. s 5 H K a/- 6� Panel: Residential Receptacles/Outlets 0 $000 -2 Family: 0 $01' �:e $ a to 50 HP/ 0 $0.00 0%, 1 111 t' I i: d): �7�Vfcu(7 40 WlEata'i tage 0 50 to 100 H P/KW/KVA: tl Le(d) rk Is, .00 0 $0.00 Service i;i�' Signs JO Over 100 H P/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to200A: 0 $0.0014 - Branch Circu�tl` 0 $0.00 ;hac $46.11 0 $0.00 kf-Temp-Power---IY----$U._00 'ee__ ur e ____1nv!est 0 _�i;' 0-600V over 20OA: Q01r1o_!Fee—� $0.00 Temp Power Pole: 0 Over 600V or 1 OOOA: 0 $0.06'�e t4dd Circuit: $37.00 I` $019f1sp. O/H to U/G 0 so ' 001 - Additional Fee $0.00 — ----- �Fee-_- $0.00 TOTAL Fee $136.1 ��P rOMM'tMe 97 �$'E-o �0 Fee Due at Permit Issuance: S136.11 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. Ltz Y4 JWNER-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 (_) 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 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). ❑ 1 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 legally 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 QPWRACTOR'S DECLARATION hereby,affirm urfdVI15enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S 'on 7000) of Division 3 of the Business and Professions Code, and my license is in full force ead 84t. • • • t License'Class License No 70'3 % �Z- Date Contractor Signature�— d(?Ri(ERS' COMPENSATION DECLARATION NARNING: FAILURE 70 SGOURE 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 CO �T OFC COMPENSATION, I:AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. Fherel9y affirm un r penalty of perjury one of the following declarations: dare and vwlt 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, once of thP+work for which this permit is issued. Policy No. lihav and wR 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 nsura �a c�arver un policy number are: rner 22E • 13i0` /W.5. �C1 Policy Number ©N Expiration Date ]. :. . ••• Name of Agent • Phone # 01 certify that, in the performance 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 agree that, if I should become subject to the w o nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Date' DECLARATION REGAR I CONSTRUCIMN LENDING AGENCY I hereby affirm under pe alty 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 county ordinances and state laws relating to building construction. ,.. I authorize representatives of this city or county towae,r Do I -r1li rope rty for inspection purposes. /may D Signature of Property Owner or Authorized Agent01 s Print Property Owners or Authorized Agent's Na� /7,7/[' Date �L- ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART61 OF TITLE40AND AQMD RULE 1403, ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT EXPIRED 3-�l^ZOZZ PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSEDDEMOLITION. SIGNATURE: PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED