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HomeMy WebLinkAboutE2019-0204 - Permitst City of Newport Beach - Building Division o 100 Civic Center Drive, Newport Beach, CA 92660 1 Permit Counter Phone (949)644-3288 Job Address: 1350 OCEAN FRONT E Bldg: 1 Floor: Suite: Description of Work: ELEC/TEMP. POWER POLE Inspector Area: 1 Legal Description: N TR 6466 LOT 4 Owner: BASSALY LLC Contractor: Address: PO BOX 1478 Address: SUNSET BEACH CA 90742 IIT�II ILII IIIII IIID III IIS IIID ILII III SII II MINCO CONSTRUCTION 522 EAST AIRLINE WAY GARDENA CA Phone: Phone: $0.00 1-2 Family: Con State Lie: 612429 Issued Date:04/04/2019 Lie Expire: 09/30/2020 n�� �i � Bus Lie: BT30066770 Processed By: W r� Lic Exp Date: 04/03/2020 New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0 $0.00 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 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 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 : $0.00 Electrical Permit: E2019-0204 Project No : 2151-2018 Inspection Requests Phone (949)644-3255 FEES Motors/Transformers (HP/KVA) Code Edit: 2016 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 �I Worker's Compensation Insurance 0 Carrier: BENCHMARK It Over 100 HP/KW/KVA: Policy No: CST5013107 $0.00 Expire : 06/28/2019 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 Backrremp Power: 0 $0.00 Temp Power Pole: 1 $38.00 Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: 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. ® 4 O' O 006 O •O O 0 ®0O O O 6 O O B O 0 00 O O O GCG G O O 6O0 00 O G C C G G � U 4 C G 0• O O OG G 4 G` 4 0 0 $0.00. 0 $0.00 0 $0.00' 0 $0.00' $0.00, $0.00', $0.00' $35.00' $0.00 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 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). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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). 1, 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 pply 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). I am exempt from licensure under the Contractors' State 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 one year prior to completion of the improvements covered by this permit, I cannot legally ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commen Ing R Secti 7 O) of ivJ ion 3 of the Business and PeTHOU/D and n y licen e�is in full force nd effect. icense Class License No / D to `� Contractor Signatur VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOY T CRIM AL PENALTIES AND CIVIL FINES UP TO ONE H LARS ($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: 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 erformance of the work for which this permit is issued. Policy No. 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' rance carrier a bitlicv number ak9 . A Expiration Date of Agent certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' if I should become��a/ybject to the e c pe ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. tature of Applicant �/�ti �/^'./�' Date ,eby affirm under penal of peijury th;Khere is a construction lending agency for the performance of the work for which this permit is issued Per's Name Lender's Address Ty 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 ordinanc d ate I I authorize representatives of this city or county to ante derc ACT70N I DATE PERMITEXPfRED PERMITFINAL CERTfFfCATEOF OCCUPANCY7SSOED relating to building construction. Orly for inspection purposes. Print Prooertv Owner's FEDERQt, RIW/LAT(ONS PART 61 OFTITLE40AND AQM©RNL 03. . .0. : .' l p I&VBMtfFEE6AM7psnt2n:WT;47*.TO: 0. • EP21' 0 AQMD 0 ASBESTOS NOTIRCATTONiS NOTAPPL7CABLE TO PROPOSFDDEV7L{T70N.. ... S7GNAAR9: .: : : ', ', laws of California, and