HomeMy WebLinkAboutE2018-0182 - Permits-,� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIII�IIIIIIIIDIIIIIIII�III�IIII JillElectrical Permit: E2018-0182
100 Civic Center Drive, Newport Beach, CA 92660 _ Project No: 2701-2017
E: , Permit Counter Phone (949)644-3288
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a Inspection Requests Phone (949)644-3255
Job Address: 3408 MARCUS AVE Bldg: 1 Floor: Suite:
Description of Work: ELEC/SUBPANEL & INSTALL LIGHTING THROUGHOUT DWELLING
Inspector Area: 1 Code Edit:2016 --�
Legal Description: CANAL SECTION BILK 334 LOT 5
Owner: WU ERIC Contractor: OWNER/BLDR Worker's Compensation Insurance -
Address: 3408 MARCUS AVE Address: AUTH AGENT: Carrier
NEWPORT BEACH CA 92663 NATHAN PHILLIPS Policy No:
Phone: Phone: Expire
Con State Lie: O/B
Issued Date:03/16/2018 Lie Expire:
\ Bus Lie:
Processed By: Lie Exp Date:
FEES
New Construction
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
0
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
97
$97.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
1
$25.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
0
$0.00
Low Voltage
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
0
$0.00
Service
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/remp Power:
0
$0.00
Investigation Fee:
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$33.00
O/H to U/G
0
$0.00
Additional Fee:
$0.00
Supplemental Fee:
$0.00
TOTAL Fee:
$155.00
Plan Check Fee: $0.00
Fee Due at Permit Issuance:
$155.00
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.
6
G
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 legal)
sell a structure that I have built as an owner -builder if it h n donstruc din 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,thipl!cation i I ad at th owing Web site:http://www.leginfo.ca.gov/calaw.html. ,
Signature of Property Owner or Authorized Agent Y t DatBl�
LICENSED CONTRACTOR'S DECLARATI / \
I hereby affirm under penalty Of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
and effect.
License Class License No Date Contractor Signature
WORKERS'COMPENSATION DECLARATION
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 (E100,000), 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
performance of the work for which this permit is issued. Policy No.
I 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' compensatio
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
certify that, in the rmance kn�E
rmit 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
I should becomes bject to trovisions of Section 3700 ofthe Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant ' �a}e�C
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
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 Lenders 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.
1 agree to comply With all applicable city and coun ' n - an state laws relating to building construction.
I authorize representatives of this city or county enter a abov identified property for inspection purposes. `� }
Signature of Property Owner or Authorized Ageh Print Property Owner's or Authorized Agent's Nam I
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ACTION BATE BY DECLARATION OFCOMPLIANCE iMTN CODE OF FOROffl(f USE ONLY
FEDERAL REGULATIONS PART 61' OF TITLE 4t3.AND
AQMORfiLE 1403.
PERMITE3CPf4ED
❑ f SUBMfTTE0AS8ESTOS N071FICATION TO:
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