HomeMy WebLinkAboutE2022-0064 - Permits(9)
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 2633 BAMBOO ST Bldg: 1 Floor: Suite:
Description of Work: ELEC PANEL UPGRADE 200 AMPS
Inspector Area: 2
Legal Description: N TR 4892 LOT 57
Owner: WAHLBERG GRAHAM
Contractor:
Address: 2633 BAMBOO
Address:
NEWPORT BEACH CA 92660
Phone:
Phone:
Con State Lic:
Issued Date:02102/2022
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
New Construction
Residential
Multi -Family:
0
$0.00
1-2 Family:
0
$0.00
Service
0-600V up to 20OA:
1
$47.00
0-600V over 20OA:
0
$0.00
Over 600V or 1000A:
0
$0.00
O/H to U/G
0
$0.00
AL Fee :
*E2022•-0064* Electrical Permit: E2022-0064
Project No : 2561-2021
R J H CONSTRUCTION
27071 CABOT RD#124
LAGUNA HILLS CA 92653
800-524-1612
605852
11/30/2022
BT30072691
08/31/2022
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Fixtures:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Signs
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee :
$0.00
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9020683
Expire : 08110/2022
FEES
Motors/Transformers (HPIKVA)
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 BackfTemp Power: 0 $0.00
Temp Power Pole: 0 $0.00
Check Fee :
Temp Underground:
Sub Panel:
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
Due at Permit Issuance :
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.
0
0
" 0
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forth e 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 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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U 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-Builderwill 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 Iicensure 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 CONTRACTOR'S DECLARATION
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� is in full force
and effect. C��1 ^
License Class 7 License No coo S L Dat zZ ^2' Z--L Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE Tr-,FC'JRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO ANO DOLLARS ($100,000), IN ADDITION TO THE
COST OF C'JMPENS.ATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I f�ersby zffirm under penalty of perjury one of the following declarations:
❑ 1 hav- 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, forth,
pie fgRnance of the work for which this permit is issued. Policy No.
LJ have,and will rsirtain 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
insurance carrier Pnd policy number are:
Policy Number
Date
Name of Agent Phone #
01 certify that, it, he performance of the work for which this 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 ag re
that,,if I should beccme jubje9tto the workers' compens ' n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision -.Z ! 2.11,
Signature of App:icart Date l
DECLARATION REGM ING CONSTRUC N LENDING AGENCY
I hereby affirm under penalty of perjury thaPfiere 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 law Sting to building construction.
I authorize representatives of this city or county to r the above-ide d property for inspection purposes. �ZZ
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date
ACTION
DATE
Y
DECLARATION OF COMPLIANCE IMTTN CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
AQMD RULE 1403.
PERMIT EXPIRED
P
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICA RON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:.
PERMIT FINAL
CERTrR CATS OF
OCCUPANCYISSUED