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HomeMy WebLinkAboutE2019-0611 - Permits (2)City of Newport Beach - Building Division c�' w 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 4000 MACARTHUR BLVD Bldg:1 Floor: 10 Suite: 1025 Description of Work: ELEC/RELOCATE (8) RECEPTACLES IN EXTG SUITE Inspector Area: 7 Legal Description: P BK 114 PG 22 PAR 1 Owner: 4000 MAC ARTHUR L P Address: 400 S HOPE ST #200 LOS ANGELES, CA 90071 Phone: Issued Date:08/30/2019 Processed Bv: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 714-414-7024 Con State Lic: 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee :$107.00 Il iii iiiii iiiii iiiii iiii iiiii iiiii 1 II Contractor: A TO Z ELECTRIC Address: 27814 SPRUCE 0 MISSION VIEJO CA 92692 Phone: 714-414-7024 Con State Lic: 1016212 Lic Expire: 07/31/2020 Bus Lic: BT30068722 Lic Exp Date: 08/31/2020 Receptacle/Switch/Outlets Receptacles/Outlets: 8 $8.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs $0.00 10 to 50 HP/KW/KVA: Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $64.00 Electrical Permit: E2019-0611 Project No : Inspection Requests Phone (949)644-3255 r Code Edit: 2016 //^0 Worker's Compensation Insurance per` Carrier: EXEMPT Policy No: Expire : FEES 0 $0.00 Motors/Transformers (HP/KVA) 0 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 Pale: 0 $0.00 Check Fee: $107.00 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 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. 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 (_) all of or L) 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 im roved 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 n -^f 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 licensure 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 legall: 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 SII 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 land effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION YARNING: 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 ($100,000), IN ADDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 1 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 rerformance of the work for which this permit is issued. Policy No. 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' rance carrier and policy number are: Policy Number of Agent Date certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Date DECLARATION REGARDING CONSTRUCTION LENDING AGENCY 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 ender's Name Lender's Address y 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 laws relating to building construction. 1 authorize representatives of this city or county to enter the above -identified property for inspection purposes. innature of Prooertv Owner or Authorized ADent Print Property Owner's or Authorized Agent's Name AC77ON DATE BY UCLLAK t]UAI Ur wrnruFrrvi.c rvirn wuc Ur - FEDERAL REGULATIONS PART 41OFTITLE40AND AQMO RULE 1403. PERA41TEXPIRED ❑ 1SUBMITTED ASBESTOS NOTIFICATION TO., ❑ EPA ❑ AQMD _ PERMITCANCELLED P€RWITEXTENDED ❑ ASBESTOS NORRCATTONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITFINAL s�, CERPRCATE OF SIGNATURE: OCCUPANCYISSUED Civil Code). Date