HomeMy WebLinkAboutE2021-0494 - Permits��wnat� c City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII II
d 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 4 9 4
' Permit Counter Phone (949)644-3288
Electrical Permit: E2021-0494
Project No : 1210-2021
Inspection Requests Phone (949)644.3255
Job Address: 2654 VISTA DEL ORO Bldg: 1 Floor: Suite:
Description of Work: MFR ELEC FOR MASTER BED & GUEST BED (8 NEW CANS) **ADDED SCOPE REV21-1296** (X2021-1372)
Inspector Area: 4 Code Edit: 2019
Legal Description: N TR 6996 LOT 26
Owner: ARIZA AUGUSTINE
Contractor:
O C BUILDERS GROUP INC
Worker's Compensation Insurance
Address: 2654 VISTA DEL ORO
Address:
600 W SANTA ANA BLVD #114A-499
Carrier: STATE FUND
NEWPORT BEACH, CA 92660
SANTA ANA CA 92701
Policy No: 9256608
Phone:
Phone:
714-417-7771
Expire : 06/28/2022
Con State Lic:
1052090
Issued Date:08/1912021
Lic Expire:
06/30/2023
py
Bus Lic:
BT30071659
Processed By: p
Lic Exp Date:
04/30/2022
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over 20OA: 0
Over600V or1000A: 0
O/H to U/G 0
TOTAL Fee:
o
ommems
0
m mo
0 0 0
memm
FEES
o •oo
OOV
Receptacle/Switch/Outlets
Motors/Transformers(HP/KVA)
m
°m°
Receptacles/Outlets:
0
$0.00
0to1HP/KW/KVA:
0
$0.00
Temp Underground:
0°°8
$0.00
$0.00
Fixtures:
8
$14.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$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
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$38.00
$0.00
Additional Fee:
$0.00
Supplemental Fee:
$0.00
Plan
Fee Due at Permit Issuance:
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.
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-Builderwill 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.htmi.
Signature of Progvv.Owner or Authorized Agent Date
LICENSED CLJNJIII .CTOR'S DECLARATION
i hereby affirm gder�penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profees s Code, and Jr`bense is in full force
sand efmct. • . • /
Nense Class ' " License No Date f 2C Contractor Signature
� i
WORKERS' CdMPENSATION DECLARATION
AQRI, ;: FAILURE i0 SEtU RE 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.OF COMPENSATIONy DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
lbereby affir ; sneerpenalty of perjury one of the following declarations:
ER-1-have and*wiA'tnaintain 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 the
ke-lifrurnance of the work for which this permit is issued. Policy No.
Ave and will.Aaintain 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' compensation
iA"Ance carrier and policy number are:
Cdrtier •:... : Policy Number Expiration Date
Name of Agent ' Phone #
❑I 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
that, if I should become ubject�
/to thers' com provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provision. cY'
Signature of Applicant" /T�Date
DECLARATION REGARDRR�G-G9NSTROCTIOWL-ENDING AGENCY
I hereby 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).
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 have provided is correct.
I agree to comply with all applicable city and county ordinances and ate laws relating to building construction.
I authorize representatives of this city or county _ e 1r the a I ntified property for inspection purposes.
Signature of Property Owner or Authored Agent Print Property Owners or Authorized Agents Name Dat Ia1
ACTION
DATE
BY
DECLARATION OF COMPLIANCE tMTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART6'1OFTITLE40AND
AQMD RULE 1403.
❑ 1 SUBMITTED ASBESTOS M077FICATIONTO:.
❑ EPA
❑ AQMD'
PERMtTEXPLRED
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS N077FICA77ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMIT FINAL
CERTIRCATEOF
OCCUPANCYISSUED