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Home My WebLink AboutE2018-0790 - Permits9�r1 City of Newport Beach - Building Division 11111Jill 11111p11111p1Jill 111111p1111p1111111p111 Electrical Permit: E2018-0790 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 8 0 7 9 0 Project No: 2923-2018 n: Permit Counter Phone (949)644-3288 c�° x�' - Inspection Requests Phone (949)644-3255 Job Address: 212 BAY AVE E Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE (X2018-3777) Inspector Area: 1 Code Edit: 2016 I V_ CTU Legal Description: NEWPORT BAY TR SUB OF BLK C LOT 75 Owner: 212 E BAY LLC Contractor: SEPULVEDA BUILDERS INC Worker's Compensation Insurance Address: 790 NEWTON WAY Address: 790 NEWTON WY Carrier: NO EMPLOYEES COSTA MESA CA 92627 COSTA MESA CA 92627 Polley No: < m m o 0 Phone: Phone: 714-222-1150 Expire: 0 Con State Lic: 695401 mm ° Issued Date:1 4/2018 Lic Expire: 10/31/2018 a,®mam m m 10 to 50 HP/KW/KVA: Bus Lic: BT30058100 ° 00 0 Processed B . Lic Exp Date: 02/28/2019 .... mmmm ° $0.00 omoo ° mmmme ° OOmB00 New Construction Residential Multi -Family: 0 1-2 Family: 0 Service 0-600V up to 20OA: 0-600V over 20OA: Over 600V or1000A: O/H to U/G Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 $0.00 Fixtures: 0 $0.00 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs FEES $0.00 Branch Circuit: Motors/Transformers (HP/KVA) 0 $0.00 0 to 1 H P/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 0 $0.00 Branch Circuit: 0 $0.00 0 $0.00 Each Add Circuit: 0 $0.00 Piggy BackrFemp Power: 0 $0.00 0 $0.00 Time Clacks: 0 $0.00 Temp Power Pole: 1 $38.00 0 $0.00 Additional Fee: $0.00 :ee : $73.00 Plan Check Fee: $0.00 Temp Underground Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Fee Due at Permit 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. m ®°iQ• 0o m 0 o m 00 00 o Demo $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 NNER-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) action 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 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 ifessions 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 t 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, siness 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 3rovements 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 Droved 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 oly 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: 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 I 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 Aessions Code, is available upon request when this application is submitted or at the following Web site:hfp://www.leginfo.ca.gov/calaw.html. (nature of Praory Owner or Authorized Agent Date ;EN§ED CONTRACTOR'S DECLARATION ere"ffirm under p onalty of perjury that I am licensed under provisions of Chapter 9 (commel cing with Section 70 0) of Division 3 of he Business alit�Professions_ e,—and my license is in full force Jeffect. •• • / /p^� Qnst.Class License No ate !/ v[ C ac Signatures. AkERS' COMP,��F.NSATION DECLARATION iNING. FAILURE 1Q g ftRE 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 STOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION OTOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. •• watry affirm unrjeo penalty of perjury one of the following declarations: 1'have and wil 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 IN V Mince of tlge work for which this permit is issued. Policy No. (,nave and X mair�ain 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 WIG carrier angpolicy number are: TierPolicy Number Expiration Date Tie of Agent •.• _._ - _ _..._ _ _.. _ Phone -# ertify 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 becomethe workers' compensation laws of California, and if I should become subjecKo ft workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comp) ose proyisions. Ueby 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 Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners 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. I authorize representatives of county to the ve-identified property for inspection purposes. nature of Property Ownev6 thorized Agent r�Print Property Owner's or Autho ' ed A 's Name / )c-- uIW ACTION DATE BY DECLARATION OF COMPLIANCEl46TH CODEOF FDR OFFICE LJSEbXrY FEDERAL REGULATIONSPART 61 OF TTR-E4OAND AQM13RULE 1403. PERMIT EXPIRED ❑ I SUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA PERMIT CANCELLED ❑ AOMD PERMIT EXTENDED PROPOSED DEMOLITION.RONISNOT APPLICABLE TO PERMITFINAL —21_1' ti� AZ SL CERTIFICATE OF OCCUPANCYISSUED SIGNATURE: