HomeMy WebLinkAboutE2022-0349 - PermitsCity of Newport Beach - Building Division
�.� 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 110 APOLENA AVE Bldg: 1 Floor: Suite.
Description of Work: ELEC TEMP POWER POLE
Inspector Area: 2
Legal Description: BALBOA ISLAND SEC 3 BLK 6 LOT 25
Owner: BURNS CLINT
Contractor:
Address: 110 APOLENA AV
Address:
NEWPORT BEACH CA 92662
Phone:
Phone:
Issued Date:06/08/2022
Can State Lic:
Lic Expire:
Processed By:
Bus Lic:
Exp Date:
IIIIIII IIII IIIIIIIII IIIII IIIIIIIII IIII IIIIII IIIII III IIII
VITARELLI CONSTRUCTION INC
140 S BAY FRONT
NEWPORT BEACH CA 92662
949-677-1872
485418
02/28/2023
BT00011199
08/31/2022
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
Service
Low Voltage
0
$0.00
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
0
$0.00
Additional Fee:
$0.00
TOTAL Fee : $79.00 Plan Check
Electrical Permit: E2022-0349
Project No : 0170-2022
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: STATE COMP INS FUND
Policy No: 0783123
Expire : 10/01/2022
FEES
Motors/Transformers (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 Back/Temp Power: 0 $0.00
Temp Power Pole: 1 $41.00
Temp Underground:
Sub Panel:
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
Fee Due at Permit Ise
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.
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$38.00
$0.00
Y
)WNER-BUILDER DECLARATION
ode: An 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
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 C Y Y
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
he permit to file a signed statement that he or she is licensed pursuant t0 the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business an
not more than five hundred dollars ($500). portions of the work, and the structure is not intended or offered for sale (Section 7044,
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L)
he
Business
and are not intended Code: d or offered for Contractors'
ale. State License
, thew does
o s riotapply
improvement n o snsoldfwithneone year of completorty who, through lnYthe Owner -Builder will have the n burden of proving improves the that itpwas n of build that t
improved for the purpose of sale). Buiness and
apply to an ner of th I as oweeoperty, who builds exclusively
vei y contracting
with licensed
who contracts for the projects with project
(Sesed Contractor 044,pus uant to her Contractors' State License rLaw)s' State License Law does no
I am exempt from licensure under the Contractors' State License Law for the following reason:
By ayssructure that I halve built le age that,
e-bully
edenf i has been constructed ndence in l itslentirety by licensed must have resided fcontracto s. I undersor at least one year tand that a COPY of the appl gable law, Section 7044 tof the Buhis lsinessnandnot lega
Profe,,=ions Code, is available upon request when this application is submitted or at the following Web site:http:/Iwww.ieginfo.ca.gov/calaw.html-
profe,,F'jons
Sionature of Propel owner or Authorized Agent d m icense is in full force
LICENSED CON RACTOR'S DECLARATION (commencing with Section 7000) of Division 3 of the Business and Prof
I hereby affirm unJer penalty of perjury that I am licensed under provisions of Chapter 9 (como e, a `y
and effect. Dat - - -a Contractor Signatur
License Class_; License No
HE
VIORKERS' COMPENSATION DECLARATION
CRIMINAL PENALTIES AND CIVIL FINES UP TOO
cARNING`j ILURE T ION CURE WORKERS'
COMPE FOR IN SECTION OVER GE 1OF THE LA90R CODE, INTEREST, AND ATTORNEY'S FEES.
NE H DRIED THOUSAND DOLLARS ($t00,000), IN ADDITION TO T
MPEN
OVIDED
I hue)y affirm udder pe,Ialty 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 tY
performance of the work for which this permit is issued. Policy No.
ve 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' compensatlo
suran carrier and policy number are: Expiration Date
Policy Number Phone #
u�
me of Agent
II certify that, in the t, becomub ect t performance of the work
for whichsthis atin pe`mitsions of Selction113700not eof the Labor Code,any person ll hall forthwith complyn any manner so as to bwith hose p ovit oche workers' compensation laws of California, an agree
Date
3nature of Applican
CLARATION REG DI CONSTRUCTION LENDING AGENCY
ereby affirm under penalty of perjury that there is a construction lending agency for the peer Address
of the work for which this permit is issued (Section 3097, Civil Code).
Len
er's
nder's Name
r 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 ord. ses and state laws relating to building construction. tom,
I authorize representatives of this city or count to me he abbV -id tifi d for inspection purposes. Ur4/i3'�Dat --0
,mature of Property Owner s Authorized Agent Print Property Owners or Authorized Agent's Name
_ __.....__..,.r... FOR OFFICE USE ONLY
ACTION DATE I BY I I FEDERAL REGULATIONS PART 51 OF
❑, I SUBMITTED ASBESTOS N077FICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS N077RCA77ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
CERTl FICATEOF I I I I SIGNATURE:
OCCUPANCYISSUED