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E2021-0471 - Permits
{ City of Newport Beach - Building Division a 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �'�t rav3N�a Job Address: 20391 BAY VIEW AVE Bldg: 1 Floor: Suite: Description of Work: SFR PANEL UPGRADE 200 AMP Inspector Area: 3 Legal Description: N TR 1501 LOT 29 Owner: WARNER CHRISTIAN Contractor: Address: 20391 BAY VIEW AVE Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:08/09/2021��� Lic Expire: Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0 $0.00 0-600V up to 20OA: 1 $47.00 0-600V over20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: IIIEII� �II0�IIIII�II�I�I I4IIIII1 II KISSEL ELECTRIC 28081 MARGUERITE PKWY MISSION VIEJO, CA 92690 949-357.8955 989355 12/31/2022 ST30067182 05/31/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs • e ° °••° ° Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : °oo© $0.00 Electrical Permit: E2021-0471 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 • • • •'. a•e• Motors/Transformers (HP/KVA) • • • eee000 Worker's Compensation Insurance • e ° °••° ° Carrier: EXEMPT •••• •ee.•° 0 Policy No: 1 to 10 HP/KW/KVA: °, • ° °„ Expire: °o o ° o •,°°° $0.00 °oo© 0 $0.00 • •0000 $0.00 •• V0000 $0.00 , ° $0.00 ° e eee•°° $0.00 00066 0 ° FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Plan Check Fee : 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. Issuance: $85.00 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 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 U all of or U 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 W4 licensure under the Contractors' State License Law for the following reason: fyatsignature 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 legall sell a ctructurt4%4?iave 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.htm[. SIVA Ure of Property Owner or Authorized Agent Date �]CFNSED GCft RACTOR'S DECLARATION Nerg% affirm Gtfdbt penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force • 2 CiMnas Class ..:. License No Date �Contractor Signatur� NIMKERS' COMPENSATION DECLARATION NI .Y•Jry2NINe: FAILURBTO 9EEURE 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 COST OPCOMPERWbN,:)AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 heRb= affirm under penalty of perjury one of the following declarations: .. "PRave and.will•..m.aintain 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, forth performance of the work for which this permit is issued. Policy No. ❑1 have 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. My workers' compensatiol insurance carrier and policy number are: Policy Number Agent Date 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 become subject to the workers' compensation laws of California, and agre if I should become subject to the ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3ture of Applicant / �i G Date � 11 " 7 r CLARATION REGARDING CONSTRUCTION LENDING AGENCY :reby 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. $y ,qA � PSC 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 enter t.above-identified property for in n purposes. p nature of Prooertv Owner or Authorized Aoent _r— Print Property Owner's or Authorized Ag 's Name ACTION DATE BY/DECLARATION OF COMPLIANCE tMTH CODE OF FOR OFFICE USE FEDERAL REGULA TIONS PART 09 OF TITLE 40 AND AQMD RULE 94033. PERMITEXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO:. ❑ EPA y' ❑ AQMD PROPOSEDDEMOURON. L`N ASBESTOS NO7IRCAHON IS NOT APPLI77) NATURE: _ "� PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIF€CATEOF OCCUPANCYISSUED