HomeMy WebLinkAboutE2021-0552 - Permits (3)an
City of Newport Beach - Building Division 11ill11111111111111111111111111111111111111111111111il100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 5 5 2
Permit Counter Phone (949)644-3288
Job Address: 117 26TH ST Bldg: 1 Floor: Suite:
Description of Work: ELEC-OVERHEAD TO UNDERGROUND. 200 AMP PANEL UPGRADE
Inspector Area:
Legal Description: NEWPORT BEACH CITY BLK 26 LOT 27
Owner: SERRA BRIAN
Contractor:
Address: 117 26TH ST
Address:
NEWPORT BEACH, CA 92663
Phone:
Phone:
Con State Lic:
Issued Date:09/03/2021
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
CONTORELLI CONSTRUCTION INC
17686 METZLER LANE
HUNTINGTON BEACH CA 92647
949-290-4630
319552
08/31/2022
BT30065552 ..r.,
01/31/2022
ux y�
New Construction
Receptacle/Switch/Outlets
Residential
Receptacles/Outlets:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Service
Signs
0-600V up to 20OA:
1
$47.00
Branch Circuit:
0
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
1
$47.00
Additional Fee :
$0.00
TOTAL
Fee:
$132.00
Plan
Electrical Permit: E2021-0552
Project No :
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9154910
Expire : 03/15/2022
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
Piggy Backlfemp Power: 0 $0.00
Temp Power Pole: 0 $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.
° . . .
O O G O O O p O
YB G°4 G Y Gi Gi YGi
'NER-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)
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
fessions 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
more than five hundred dollars ($500).
J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of c(
nproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least o
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors.
'rofessions Code, is available upon request when this application is submitted or at the following Web site: http://www.It
;ignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S on 70
nd effect.
icense Class License No Date
COMPENSATION DECLARATION
DING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
.OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
'I'm under penalty of perjury one of the following declarations:
have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Dire
)rmance of the work for which this permit is issued. Policy No.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for
rance carrier and policy number are:
ier Policy Number
1e of Agent
JI certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any me
tat, if I should become subject to the workers' 9 ns ion visions of Section 3700 of the Labor Code, I shall fol
ignature of Applicant
ECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for
ender's Name Lender's Address
y 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 city or count n er a ove-Identified property for inspection purposes.
ignature of Property Owner or Authorized Agent Print Property Owner's
the work, and the structure is not intended or offered for sale (Section 7044,
employees' or personal effort, builds or improves the property, provided that the
pletion, the Owner -Builder will have the burden of proving that it was not built or
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
e year prior to completion of the improvements covered by this permit, I cannot
understand that a copy of the applicable law, Section 7044 of the Business and
Date
Division 3 of the Business and s nss Code, and my license is in full force
Contractor Signature
TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
of Industrial Relations as provided for by Section 3700 of the Labor Code, for
performance of the work for which this permit is issued. My workers'
Date
so as to become subject to the workers' compensation laws of California, and
i comply with those provisions. `- y 1
Date y' 21
1 `
i this permit is issued (Section 3097, Civil Code).
Date zJ 1
ACTION
DATE
BY
DECLARATION OF COMPLIANCE VATH CODE OF
FOR OFFICE USE ONLY
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PERMIT FINAL
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