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HomeMy WebLinkAboutE2019-0171 - PermitsCity of Newport Beach - Building' Division IIIIIIIIIIIIIIIIIIIIIIIIIIYIIIIIIIIIIIIIIIII II 'f 160 Civic Center Drive, Newport Beach, CA 92660 E 2 6 1 9 F _ Permit Counter Phone (949)644-3288 Job Address: 438 ACACIA AVE Bldg: 1 Floor: Suite: Description of Work: ELEC -OVERHEAD TO UNDERGROUND. (2 METERS & SERVICE UPGRADE) Inspector Area: 5 Legal Description: CORONA DEL MAR BLK 429 LOT 22 Owner: LYLE MARK A Contractor: Address: 3706 BLUE KEY Address: CORONA DEL MAR, CA 92625 Phone: Phone: Con State Lie: Issg[d°D�te:03/P�/�019 �I Lie Expire: Receptacle/Switch/Outlets Bus Lie: Prgcessep By: ° ° ° Lie Exp Date: 000000 O 00000 OROSrrdential ° O 060°01 000000 CONTORELLI CONSTRUCTION INC 30832 MARILYN DR LAGUNA BEACH CA 92651 949-290-4630 319552 08/31/2020 BT30065552 01/31/2020 Electrical Permit: E2019-0171 Project No : Inspection Requests Phone (949)644-3255 ra. Code Edit:2b1,�,.11 ry U Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9154910 Expire: 03/15/2020 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction flours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:60 p.m. M FEES NemiConstrUpti©p' Receptacle/Switch/Outlets Motors/Transformers (HPIKVA) OROSrrdential ° Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 llu1tf-Familyn° °0 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 0 g;,2.F6mily: ° ° 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: D $0.00 0 $0.00 ° Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Service ° ° ° °° Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00' 0-600V up to 20OA: 2 $86.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 200A: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 O/H to U/G 2 $43.00 Additional Fee : $0.00 Supplemental Fee: $0.00' TOTAL Fee: $164.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $164.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction flours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:60 p.m. M J••,\L,\-Y V,LV L,\ - - - - - - - . . v.. 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) 1 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 Prohsalgns iyode) 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 L) 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 Eim 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 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 Iegalli 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.loginfo.ca.gov/calaw. html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti n 70001 of Division 3 of the Business and Pr f s '4 §-God - -and-my-ttoeRse is in full force and effect. y License Class License No Date // Contractor Signature "- WORKERS' COMPENSATION DECLARATION •! ! NARNMG: 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 ($100,0004 TN ADDITWA IS INE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ° • ° ° ° ° I hereby affirm under penalty of perjury one of the following declarations: 44 �h ve 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 Conti °fbP Ph, ow aeylSarloe'of the work for which this permit is issued. Policy No. • • • • • - 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. %Vy ;oraers' carrier and policy number are: ! -0.. Policy Number Date Name of Agent - F„-„= m _ _ ❑I certify that, in the pertJJ+J ance o e-wof for whic this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laWdf.CF4fornia,•and agge that, if I should becom b°ubje t orkers' compen ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applican �'"'""'-- - Date/ •����• DECLARATION REG ING CON DING AGENCY I hereby affirm under p a y o perjury that there is a construc Ion Wing agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 hav ro 5so orract. I agree to comply with all applicable city and cou ordIn s and state lawwr6raRg to building construction, I authorize representatives of this cit or count o enter he 4bov -IdellCfied property for inspection purposes. Sin naturs of Pronertv Owner or Authorized ADent. T �-�' Print Pro ertOwner's or Authorized A ent's Name `t( Date 1 ACTION I DATE 8Y 11 FFUERALREGUiATIOMSPART&4:.:GFT17LE40AAfD I SUBM17TEDAS13ESTOS N077FICATION TO. 0 EFA 0 AQMD ASnF.STOS NOTIFICATION IS NOT APPLICABLE TO PERMIT FINAL SIGNATURE: DCCUPANCYISSUED