HomeMy WebLinkAboutE2021-0081 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
. a? 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 0 8 1
Permit Counter Phone (949)644-3288
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Job Address: 4695 MACARTHUR CT Bldg: 1 Floor: 12 Suite:
Description of Work: COMM CONNECT NEW 20 A RECEPTACLE TO EXISTING SINGLEPOLE BREAKER
Inspector Area: 7
Legal Description: P BK 196 PG 40 PAR 2
Owner: IRVINE CO
Contractor:
Address: 550 NEWPORT CENTER DR
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Con State Lic:
Issued Date:07/06/2021
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
New Construction
Residential
Multi -Family:
0
$0.00
1-2 Family:
0
$0.00
Service
0-600V up to 200A:
0
$0.00
0-600V over 200A:
0
$0.00
0ver600V orI000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL
Fee:
$41.27
ACCO ENGINEERED SYSTEMS INC
888 EAST WALNUT ST
PASADENA CA 91101
818-244-6571
120696
12/31/2021
ST00004502
12/31/2021
Receptacle/Switch/Outlets
Receptacles/Outlets: 1 $1.75
Fixtures:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Signs
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0,00
Time Clocks:
0
$0.00
Additional Fee :
$0.00
Electrical Permit: E2O21-0081
Project No: 0271-2021
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: ARCH INSURANCE
Policy No: 74WC188949003
Expire : 1010112021
FEES
Motors/Transformers (HPIKVA)
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 Back/Temp Power: 0 $0.00
Temp Power Pole: 0 $0.00
Plan Check Fee :
"�- � P
Temp Underground:
0 $0.00
Sub Panel:
0 $0.00
0 $0.00
0 $0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$1.52
Investigation Fee:
$0.00
Issuance Fee:
$38.00
Supplemental Fee:
$0.00
Fee Due at Permit
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hpurs: Monday_- Friday 7:Oaa.m. to 6:30p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
OWNER -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 (_) 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).
❑ 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
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 Iicensure 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 Iega11
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.govlcalaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProfipAsions Code, and my license is in full force
and effect. -7 1(, t � \
License Class License No Date 1 Contractor Signatures,/_
NORKERS' COMPENSATION DECLARATION ✓/�
NARNING: 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 ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
3Jiioyarance of the work for which this permit is issued. Policy No. -
and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
carrier and policy number are:
Policy Number Expiration Date
of Agent Phone #
I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
that, if I should become su Nett to theyvof'@ra�e$mpensa�rovisions of Section 3700 of the Labor Cade, I shall forthwith comply with those provision
Signature of Applicant _.a Datef�_/
DECLARATION REGARDING CO UCTIO NDING 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.
1 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 county t e above-i ified property for inspection purposes.
Signature of Property Owner or Authorized Agen4 ' A _ Print Property Owner's or Authorized Agent's Name ��-Q.(L C J e Date 7 I b I L6Z 1
ACTION
DATE
BY
DECLARATION OF COMPLIANCE l47TH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 41 OF TI71. F40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS NOTf4CAT'ON TUr
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
ASBESPERMIT
PROPOSED TDEMOLIT ON OS LION IS NOT APPLICABLE TO
FINAL
/- , - J�j2 t
-
CERTIFICATEOF
OCCUPANCYISSUED
SIGNATURE: