HomeMy WebLinkAboutE2021-0152 - Permits9 �t City of Newport Beach - Building Division IIII�IIIIIIII�IIIIIIIIIIIII�IIIIIII�III�IIII II Electrical Permit: E2021-0152
L 100 Civic Center Drive, Newport. Beach, CA 92660 P Project No
'. n, Permit Counter Phone (949)644-3288
'+tew»�'s
- Inspection Requests Phone (949)644-3255
Job Address: 126 BALBOA BLVD E Bldg: 1 Floor: Suite:
Description of Work: ELEC (3) DISCONNECTS NO CONSTROCTION NOISE
Inspector Area: 1 Code Edit:2019 7
Legal Description: EAST NEWPORT BILK 1 LOT 20 ON SATURDAYS
Owner: PARISI MATTHEW Contractor: OWNER/BLDR Worker's Compensation Insurance
Address: 126 BALBOA BLVD E Address: Currier : •, °
NEWPORT BEACH, CA 92661 Policy No: ® ° • ®° ° °
Phone: 908-892-9210 Phone: Expire: , •° °°°
Con State Lic: O/B • • , • • °
IssuedDate:02/23/2021 Lic Expire: `ee° •° o°o
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Processed By: �5e • oe o
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FEES
New Construction
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
0
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
3
$84.00
1-2 Family:
0
$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
Service
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record-Mgm€ Fee:
$0.00
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy Backrfemp 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:
$37.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL
Fee : $121.00
Plan Check Fee: $0.00
Fee Due at Permit Issuance:
$121.00
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.
/NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
ction 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
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
Af Salons 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
ore than five hundred dollars ($500).
as owner of the property, or my employees with wages as their sole compensation, will do,L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
;inKs and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
,rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
,roved for the purpose of sale).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
Ily to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
my signature below I acknowledge that, except for my personal residence in WNW must have resided for at least one year prior to completion of the improvements covered by this permit, 1 cannot legal
a structure that I have built as an owner-builde if i has not been constructed ' ' s entirety by licensed contractors. I understand that a copy of the applicable law, Section 044 of the Business and
fessions Code,,isr available upon request when:t ' applicationat the following Web site:http://w .leginfo.ca.gov/calaw.html. r
nature of PTgppitybwneror Authorized Agent Dat t'
USED CQNTR,ACTOR'S DECLARATI
Ireby affirrr%n�br Qenalty of perjury that I am licensed under pr io s of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
;p§2 Class ' License No Date Contractor Signature
)IRK•ERS' 6bMPENSATION DECLARATION
tyI$IG: 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 ($100,000), IN ADDITION TO THE
IT OF COMPEMSAJIOR,pAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES.
.reby affirm 6der'penalty of perjury one of the following declarations:
.We and wit maintain a certificate of consent to self -insure for workers' compensation, issued by the
arrriince of�fle w% for which this permit is issued. Policy No.
Have and will mairjtain workers' compensation insurance, as required by Section 3700 of the Labor Code,
made carrier %rdpolicy number are:
ier Policy Number
of Agent
Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
for the performance of the work for which this permit is issued. My workers'
Date
11 certify that, in the performance of the work for hic this permit is issued, I shall not employ any person in any manner so as to become subject to a workers' compensation laws of California, and agre
iet, if I should become s bject to th nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi�i s.
Iignature of Applicant Date
IECLARATION REGA DIN NST ON LENDING AGENCY - -
hereby affirm under pe ally of perju there is a construction lending agency for the performance of the work for which this permit is issued (Sec ion 3097, Civil Code).
ender's Name Lender's Address --
ly 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 ou fy ordinanc state laws relating to building construction.
I authorize representatives of this city or couklivu e it ve-i ntified property for inspection purposes.
II ACTION DATE BY OFCOMPLIANC€MTN CODE OF r FOR OFFICE USE ONLY
FINAL
OCCUPANCYISSUED
❑ ISOBMITTEUASBESTOSNOTIFICATIONTO:.
❑ EPA
❑ AQMO
❑ ASBESTOS N017RCAiIONISNOT APPLICABLE TO
PROPOSEDDEMOUTION.
SIGNATURE.,