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Home My WebLink AboutE2020-0617 - Permitsx1 rr;�, City of Newport Beach - Building Division .` 100 Civic Center Drive, Newport Beach, CA 92660 ,� ' ' E' Permit Counter Phone (949)644-3288 u LL s 3 t'��vriAHla Job Address: 4508 BALBOA BLVD W Bldg: 1 Floor: Suite: Description of Work: ELEC/OVERHEAD TO UNDERGROUND Inspector Area: 1 Legal Description: N TR 15935 LOT 69 Owner: ISA Address: 4508 ALBOA BLVD NEWPO T BEACH CA 92663 Phone: Issued Processed By: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 1 $46.00 0-600V over 20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: E�� 2�� 0� 2�� 0�� 0�� 6 � 17 II Contractor: CONTORELLI CONSTRUCTION INC Address: 30832 MARILYN DR LAGUNA BEACH CA 92651 Phone: 949-290-4630 Con State Lic: 319552 Lic Expire: 08/31/2022 Bus Lic: BT30065552 Lic Exp Date: 01/3112021 Receptacle/SwitchlOutlets 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 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 Electrical Permit: E2020-0617 --�' Project No : Inspection Requests Phone (949)644-3255 l S�-CUT N Code Edit: 2019 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9154910 Expire : 03/15/2021 - FEES Motors/Transformers (HPIKVA) 0 to 1 HP/KW/KVA: 0 $0.00 1 to 10 HP/KWIKVA: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KWIKVA: 0 $0.00 Piggy BacklTemp 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: $37.00 Supplemental Fee: $0.00 ie at Permit Issuance : $83.00 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. DWNER-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 1000) a 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). ❑ 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 f om 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 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 F mfessibns Coda. is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govicalaw.html. Signatum of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hAreb,, affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 000) of D' ision 3 of the Business and Professio C nd y is in full force aad affect �7 L Contractor Si License Class License No Date gnature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPL YER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTOR EY'S FEES. I nereby affirm under penalty of perjury one of the following declarations: U I hay., a wr.l n,&intain 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 th �rbTrRanc�f thr'vork for which this permit is issued. Policy No. hav 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' compensatiol ua carrier and policy number are: er Policy Number Expiration Date ne of Agent Phone # certify that, in the performance of the work for which this permit' ssu shall not employ any person in any manner so as to become subject to the workers' compens IT laws of C Ifornia, and agre I, if I should become subject tottv e ' co tion pro Ions ction 3700 of the Labor Code, I shall forthwith comply with those provisions. - nature of Applicant _ Date CLARATION REG DING CONSTRUCTION LENDING AGENCY Ireby affirm under enalty 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). ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. 1 have read this application and the information I have provided is correct. I agree to Comply with all applicable city and county ance nd s s sting to building n purposes. I authorize representatives of this city or count o e th o e en d r erty for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name - `- Date r�7� ACTION DATE BY DECLARATIONOF COMPLIANCE VYITH CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART61 OF TITLE40AND PERMIT EXPIRED AQMDRULE1403. ❑ /SUBMITTED ASBESTOS NOTIFICATION TO: PERMFF CANCELLED ❑ EPA PERMIT EXTENDED ❑ AQMD ❑ ASBESTOS PERMIT FINAL -Z -'Z PR POS DDEMOLITION.UONIS NOT APPLICABLE TO CERTIFICATEOF SIGNATURE: OCCUPANCYMUED $ CU \ { q ! cc k% - _ lx/)! �k f $`■ § ; CL E\)j I2 |\ ! 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