HomeMy WebLinkAboutE2020-0521 - Permitswr City of Newport Beach - Building Division
y4 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Illla�!!!!!!!!!�q III Project is l Permit: E2020-0521
NO CONSTRUCTION NOISEnspection Requests Phone (949)644-3255
Job Address: 206 40TH ST Bldg: 1 Floor: Suite:
Description of Work: MECH/OVERHEAD TO UNDERGROUND WI(E) SERVICE PANEL UPWUATURDAYS
Inspector Area:
Legal Description: CANAL SECTION BLK 139 LOT 4
Owner: STANLEY ANN M Contractor:
Address: PO BOX 3234 Address:
NEWPORT BEACH, CA 92659
Phone: Phone:
Con State Lic:
Issued Date:09/29/2020 Lic Expire:
Bus Lic:
Processed By: '�. Lic Exp Date:
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 1
0-600V over20OA: 0
Over600V or1000A: 0
O/H to U/G 1
CONTORELLI CONSTRUCTION INC
30832 MARILYN DR
LAGUNA BEACH CA 92651
949-290-4630
319552
08/31/2022
BT30065552
01/31/2021
Code Edit: 2019
Worker's Compensation Insurance
^�
Carrier: STATE FUND
Policy No: 9154910
Expire: 03/15/2021
0
i
FEES
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Receptacles/Outlets:
0
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
$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
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
$46.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$37.00
$46.00
Additional Fee:
$0.00
Supplemental Fee:
$0.00
TOTAL Fee: $129.00
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.
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IWNER-BUILDER DECLARATION
'^ I flerebv 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)
iection 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
Ie 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
rofessions 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
of more than five hundred dollars ($500).
11, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
usiness 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
nprovements 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
nproved for the purpose of sale).
J I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 71
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra
I I am exempt from licensure under the Contractors' Stale License Law for the following reason:
ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least c
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors.
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.l
signature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700
ind effect.
.icense Class License NoDate
VORKERS' COMPENSATION DECLARATION
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
s year prior to completion of the improvements covered by this permit, I cannot
understand that a copy of the applicable law, Section 7044 of the Business and
of
Date
m 3 of the Business and Profes " ns ode n my iEens ' • in full force
Contractor Signatu /
IARNING: 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 1E100,0001, IN ADDmON TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNE 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 Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
erfPrmance of the work for which this permit is issued. Policy No. j
I have and will fain 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
Isurance carver nd p Icy number a�r�,)
;artier 1 " , oliey I 1 -§ Expiration Date
Tie of Agent 9� : "L= I Phone #
certify that, in the performance of the work for which this permit is. issued, I shall not employ any person in any manrIer so as to become subject to the workers' compensation laws of California, and agreE
t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant _ y//
lcy
CLARATION REGA G CONSTRUCTION LENDING AGENCY ---may ireby 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).
Ider's Name Lenders Address
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 ordina s and state I s r i g to building construction.
I authorize representatives of this city or county cto Ante ab a it'. �pr y for inspection purposes.
nature of Prooertv Owner or Authorized Acent . Print Prooertv Owners or uthorized Anent's Name .fh/ note .Ld9T/Y
ACTION DATE BY UIZI-L ;OUR Ur 1-umruxrvL.t VVJJH T.vuc ur FOR OFFICE USE ONLY 6 '
•fE9E.f2AL REQ(/34JJVNS PART 61'� OF 17TL.E40AND
PERMITEXPIRED ,6QMPRUL61 3. • ••• •'
�] :I SUBh01f0ABE; TQS J"CATION TO:
PERMITCANCELLED • 0 EpO• •••
PERMITEXTENDED ❑ AQMD
❑ ASBESTOS M017HCA170NIS NOT APPLICABLE TO
PERMITFINAL fF1LiRdSSEq OEMQLJTION.
CERTLFICATE OF : : • • • • • • • • •:
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QCCUPANCYtSSUED �_ _ • • • • •