HomeMy WebLinkAboutE2019-0229 - Permits,$ City of Newport Beach - Building Division 11IIIJill IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 11 Electrical Permit: E2019-0229
. `.. 100 Civic Center Drive, Newport Beach, CA 92660 E 2 6 1 9 e 2 2 9 Project No : 1260-2018
n: Permit Counter Phone (949)644-3288
nr�k Inspection Requests Phone (949)644-3255
Job Address: 2 CAPE ANDOVER Bldg: 1 Floor: Suite:
Description of Work: ELEC -137 ADD'L OUTLETS (X2018-3032)
Inspector Area:
Legal Description:
3
N TR 15012 LOT 7
Owner: RABBITT CRIS & SHELLY
Contractor:
Address: 2 CAPE ANDOVER
Address:
NEWPORT BEACH, CA 92660
$0.00
Phone: 424-147 4110
Phone:
$0.00
Con State Lic:
Issued Date:04e181201,9
Lic Expire:
E
Bus Lic:
Processed By:
Lic Exp Date:
e��v,
$0.00
0
0
`
° N41Construution
Residential c �
oWbItioFam4:0
1-2 Family:, 0
Service
0-600V up to 20OA: 0
0-600V over 20OA: 0
Over 600V or1000A: 0
O/H to U/G 0
WILLHOIT CONSTRUCTION INC
1278 GLENNEYRE ST #213
LAGUNA BEACH CA 92651
949-285-5444
941138
11/30/2020
BT30040606
11/30/2019
Code Edit: 2016
Worker's Compensation Insurance
Carrier : ESG
Policy No: WC1067643
Expire : 04/01/2020
ev
t
FEES
Receptacle/Switch/Outlets
$0.00
Receptacles/Outlets:
137$137.00
$0.00
Fixtures:
0
$0.00
$0.00
Sep Circuits:
0
$0.00
0
Low Voltage
0
$0.00
$0.00
Signs
0
$0.00
$0.00
Branch Circuit:
0
$0.00
$0.00
Each Add Circuit:
0
$0.00
$0.00
Time Clocks:
0
$0.00
$0.00
Additional Fee :
$0.00
172.00
Plan
Code Edit: 2016
Worker's Compensation Insurance
Carrier : ESG
Policy No: WC1067643
Expire : 04/01/2020
ev
t
FEES
0
$0.00
Motors/Transformers (HP/KVA)
0
$0.00
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/remp Power: 0 $0.00
Temp Power Pole: 0 $0.00
Fee :
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
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 (_) 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
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 licensure 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
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Division 3 of the Business and Projossions Codeand my license is in full force.
and effect a
License Class License No Dat'00
Contractor Signatur / I / ••••
WORKERS' COMPENSATION DECLARATION ~—~ jlr
p eo°000
NARNING: 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 ($ip�Opnril� AODITIQN TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. • • + ° °
i00000
hereby affirm under penalty of perjury one of the following declarations: •
°coon
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 JM2 L tlor. Cod@° tgl°tbr
rmance of the work for which this permit is issued. Policy No. • • • ° ° °
9eave 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. M;wvI;kQus' compensation
ns nca carrier and policy number are: • • ° ° °
er Policy Number Expiration Date
Vame of Agent Phone # ' ": • ° a
s••s oo•°°o
:1I certify that, in the performance of t e work for which this permitis issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of. �aalifornia, £nd agr
:hat, if I should become ,subject t workers' compensation ' 'ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicartt - Dar9/
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY rY�'
Ireby 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 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.
I authorize representatives of this city or county to ante th bove-identified property for inspection purposes.
nature of PfODertv Owner or Authorized ADer�l►� / Print Prooertv Owner's or Authorized AGent's Name't diAlf n MAOlA Date
ACTION DATE BY
urLL M rIVIV Ur LVMI-MAIN-Cmi"LVVCVr
tUKUPf1LEUSt UIVtY
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FEDERAL REGULA77ONSPART OI OF TITLE40AND
AQMD.RULE 9403.
PERMfT€XPIRED
❑ISUBMITTEDASBESTOSMORFICATIONTO:
❑ EPA
❑ AQMD
PERMITCANCELLED
P€RMITEXTENDED
ASBESTOS RONIS NOT APPLICABLE TO
0 OPOSED DEMOLITION.
PERMIT FINAL A ,
CERTIFICATEOF
OCCUPANCYISSUED
SIGNATURE: