HomeMy WebLinkAboutE2020-0393 - Permitsr Cityof Newport Beach - Building Division II�IIIIIIIIUIIIIIIII�IIIUIII�IIIIIIII�IIIIIIII III Electrical Permit: E2020-0393
`- ` 100 Civ c (^.o Aor Drive, Newport Beach, CA 92660
Project No
>s, �. Permit Counter Phone (949)6443288
0�y��,t ��> Inspection Requests Phone (949)644-3255
Job Address: 209 43RD ST Bldg: 1 Floor: Suite: -
Description of Work: ELEC/OVERHEAD TO UNDERGROUND
Inspector Area:
Legal Description: CANAL SECTION BILK 143 LOT 10
Owner: GIBSON DOUGLAS JOHN
Contractor:
Address: 209 43RD ST
Address:
NEWPORT BEACH, CA 92663
Phone:
Phone:
Con State Lic:
Issued Date:08/05/2020
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
CONTORELLI CONSTRUCTION INC
30832 MARILYN DR
LAGUNA BEACH CA 92651
949-290-4630
319552
08/31/2020
ST30065552
01/31/2021
New Construction
Receptacle/Switch/Outlets
Residential
Receptacles/Outlets:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Service
Signs
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
2
$90.00
Additional Fee:
$0.00
0
Code Edit: 2019
�g�
l �9
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9154910
Expire : 03/1512021
7-1
FEES
Motorsrrransfonners (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 Backrremp Power: 0 $0.00
Temp Power Pole: 0 $0.00
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:
$35.00
Supplemental Fee:
$0.00
Fee Due at Permit Issuance :
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VAUD INSPECTION
Construction Hours: Monday - Friday 7 00 a.m. to 6: 0 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
B (J O O J (l O• O O
O O O CJO O O
O O @ O ODG JO
O O
V B OV O 00 O O
c c e u o 0
DINNER -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 tmthe 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 L) 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 70�4, 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 Iicensure under the Contractors' State License Law for the following reason:
By my signature below 1 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 legallj
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:hftp://w .leg info.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under pena of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70001 ivision 3 of the Business and Prof " n C de, y li �ii In full force
and effect. �/
License Class License No / Date 1!/-.(� Contractor Signature a•
COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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 Dire
erformance 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
isurance carrier and.aollicv number am; --
is of Agent t -:- - 4 .3) [/t
certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any
, if I should become sUISject to the wodk p' cgmpensFtiQ I provisions cy,Section 3700 of the Labor Code, I shall
nature of Applican 0 6
CLARATION REGf RIDING CORSTJXLICTION LENDING AGENCY
�reby affirm under enalty of perjury that there is a construction lending agency for the performance of the work 1
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 owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and counttt��� ordman and ate I Ws relating b ' ing construction.
I authorize representatives of this city or county to%nte a by dEnt i6 rt ection purposes.
mature of Property Owner or Authorized Agent � Print Property Owner
CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
of Industrial Relations as provided for by Section 3700 of the Labor Code, for
performance of the work for which this permit is issued. My workers'
Date
so as to become subject to the workers' compens ion laws of California, and agre
h comply with those provisio s.
Date
i this permit is issued (Section 3097, Civil Code).
ACTION
DATE
RY
DECLARATION OF COMPLIANCE WITH CODEOF
FOR OFFICE USE ONLY
REGt�LAT/QN5 PART fig, Of TITLE40AND
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❑ ASBESTOS IVO1IRC41ION1S NOT APPLICABLE TO
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PERMITUPIRED
PERMfTCANCELLED
PERMITEXTENDED
PERMIT FINAL
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CERTIFICATEOF
OCCUPANCYISSUED
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