HomeMy WebLinkAboutE2017-0651 - Permits9
City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Job Address: 504
Description of Work:
Date: /1-1-17
Electrical Permit: E2017-0651
If applicable: Inspection-Reques Phone (949)644-3255
El80% or O 100% refund
V to whom:
Inspector Area: 5
Code Edit: 2016
in Legal Description: PM 31 RO 20 -``,)
38 0 tRg_E
TOGETHER
Owner: COLOVER HEA1 AER SHAINA� Contractor: D S C ELECTRIC INC
Address: 504 NARCISSUS AVE Address: 315 1/2 APOLEN Worker's Compensation IIsurance
CORONA DEL R, 25 •
Carr' r WESCO INS y
ORT BEA 92 62 { ► °� rd
Phone: a 4-1362 OdC�t���x/C3274 90
Con Statgggg: 1018417 Pr
M1�2018
Issued Date:12/18/2017 (workcSdiRlea) 09/30/2018 (no Work started)
Bus Lic: BT30056615
Processed By: Lic Exp Date: 09/30/2018
Insp. initials: PA "P°"7
7ftsidennflal
Receptacle/Switch/Outlets Motors/Transformers (HP/KVA)
Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00
0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 00 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00
$0.00 0 $0.00
Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00
Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00
0-600V up to 200A: 1 $41.00 Branch Circuit: 0 $0.00
0-600V over 200A: 0 $0.00 Each Add Circuit: 0 Plan Check Fee: $0.00
Over60or OA: 0 $0.00 Time Clocks: 0 $0.00 Piggy BackfTemp Power: 0 $0.00 Investigation Fee: $0.00
O/H to U/G 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $33.00
$0.00 Additional Fee : $0.00 Supplemental Fee: $0.00
TOTAL Fee : $74.00 Plan Check Fee : $0.00
Fee Due at Permit Issuance: $74.00
PERMITS4VIf ft ;.180 DAYS Ai;TER ISjgA jCE OR LAST VALID INSPECTION
Construction Hours: M0W1ay! Friday F.00ma.En, to t.,30ep.m. and Saturday from 8:00 a.m. to 6:00 p.m.
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DWNER-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 in uanc , also
requires ir of the applicant
and
the permit to file a signed statement that he or she is licensed u uan to a C3Q
Professions Code) or that he rom Icensure an a asis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit bjects the applicant to a civil penalty of
not more than five hundred d llars ($500). /1— / — / �t
rtro ki{{✓$the structure is not intend or offered for sale (Section 7044,
J I, as owner of the ptbpe
3usiness and ProfessiOlis C
mprovements are not ASTI
mproved for the purpose of
I, as owner of the pr"ape
apply to an owner of proper
J I am exempt from I
By my signature below
sell a structure that I N
Professions Code, is a
Signature of Property C
LICENSED CONTIR
I hereby affirm under p
and effect.
License Class
OST OF COMPENSATION, DID,IAG
hereby affirm under pen@Ity
I have and will maintain
erff�nce of the work for,
71 have and wijfmaintain
isurance carrier rid policy
or r 61fttPes with wages as their sole compensation will do_( 1 an of or U po n
;: The Contractors' State License Law does not apply to an owner of property who, through employees' �or npee�rs.go�na��l �effort, builds or
oer
or offered for sale. If, however, the buildin or im rove tis so hin ne yearE7S ®�n�i t. --I I M70r yg�fyh
e).
am xclusivel[Ontr ing with li C constru of (Section 7044, Business and Professions Code: Theonfc *hbMnt to the Contractors' State Lia
,ho ilds or ives re o a r c li C aun ctors' L rise L or the ollowmg reason: - -
Nledge that, except for my personal residence in which I must In for atactora. I undersleast one year tand that a copy of therior to i�ompletion of happl cable
as ftp(^Pru^r' i'!er if o�eer oe: improveii
ed i tY r rg a i,r wwwJeoinfo.ca.00v/calaw.htmI. --
License No
perjury one of the
LIREcertificate of condc�lara
P
sa9FY
ch this permit is. issued. Policy No.
of Chap er 9 (commencing with Section 7000) of Division 3 of the Business a e.
Date — do— Contractor Signature
N RESTEAND AE P FE CRI Ij8 Tai vl FINP[aff DRED'
n�. world starte�Ir i ��
�rkers' compensation, issued by a vector o Industrial a ations as provided for
proves the property, provided that the
'den of proving that it was not built or
State License Law does not
Law).
scovered by this permit, I cannot
Section 7044 of the Business and
Date
my license is in full force
DOLLARS ($700,000), IN ADDITION TO
Section 3700 of the Labor Code, for
which this p mit is issued. My workers'
ne of Agent'
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 agree
if I should become subjec the workers' c mpensat, provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p ovisions. ))
1 7
nature of Applicant
CLARATION REGAR ONSTRUCTION LENDING AGENCY
weby affirm, pegalty of perjury that there is a construction lending agency for the performance Lender's Address of the work for which this permit is issued (Section 3097, Civil Code).
Ider's Name
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 cit or count i ter the ab identified property for inspection purposes.
�T
,,,ter„rA �f arnnerty Owner or Authorized Agent Print Property Owner's or Authorized Agent's Napes-I�Q D i I``� a
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OCCUPANCYISSUED •• ••• • • •• •• •••