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Home My WebLink Aboute2021-0855 - Permits9 City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 321 AVENIDA CERRITOS Bldg: 1 Floor: Suite: Description of Work: ELEC PANEL UPGRADE 200 AMPS Inspector Area: 4 Legal Description: TR 5435 (L.L.84-214024) PAR 46 Owner: AMBERLEAF INVESTMENTS LLC Contractor: Address: 2618 SAN MIGUEL DR #485 Address: NEWPORT BEACH CA 92660 Phone: 949-945-8118 Phone: Con State Lie: Issued Date:12/14/2021 Lie Expire: Bus Lie: Processed By: Lie Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 1 $47.00 0-600V over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL *E2021-0855* IMA ELECTRIC 1227 S HICKORY STREET SANTA ANA, CA 92707 714-342-6644 1070804 11/30/2022 BT30073638 11/30/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Electrical Permit: E2021-0855 Project No: 1190-2021 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance • • • •••• Carrier: NORGUARD Policy No:IMWC273730 a....• Expire : 02/26/2022 ... • ®• • • .• • • FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Additional Fee: $0.00 Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 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. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items) (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 ( j 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). I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature MOM 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 ,s41635tj*ture thaj I h%ve 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 Ptofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signatuse of Proper{y Owner or Authorized Agent Date LICE6IStD CONTRACTOR'S DECLARATION 'I hereby affirm ugQeJyECalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a drt Profession Code, and my li Be is in full force License Class .... License No Date Contractor Signature •gVr,eRS' CON}RENSATION DECLARATION C8RNING:, AF,AILURE T06ECURE 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 SCOXy.MPENSA'(ION, VQMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. I hereby 2ff ejpe of perjury one of the following declarations: • . P • mW� Sin a certificate of consent to self -insure for work m e s 'e isrf u€d by th toy of Industrial Relations as provided for by Section 3700 of the Labor Code, for thl an tFle La r for which this permit is issued. PolicyNo. I have and will maintain workers' compensation insurance, as required by action of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior insurance carrier and policy number are: Policy Number of Agent Date 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 agre that, if I should becomes bject to �e wo kern' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r _ Signature of Applicant V / Date DECLARATION REG D '6-OONSTRUCTION LENDING 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 097, 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. 6 I agree to comply withal[ applicable city and county ordinances d 9 laws lating to building construction. 1 authorize representatives of this city or county to n e-6e o -I nti " property for inspection purposes. Signature of Property Owner or Authorized Agent 1 Print Property Owner's or Authorized Agent's Name Date AL AC77ON DATE BY DECLARATION OFCOMPLfANCE MTH CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 61 OF TITLE40AND AQMDRULE I4t'13 PERMIT EXPIRED ❑ T SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD' PERMITC4.NCELLED PERMITEXTENDED I ❑ ASBESTOS N077FICA770M IS NOT APPLICABLE TO PROPOSEDDEMOLITIOM PERNffT FINAL 2S nn CERTiFICATEOF SIGNATURE: OCCUPANCYISSUED I