HomeMy WebLinkAboutE2020-0685 - Permits�arrp City of Newport Beach - Building Division
100 Civic Cen;,gpri�e, Newport Beach, CA 92660
Permit Counfer Phone (949)644-3288
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Job Address: 2100 ARALIA ST Bldg: 1 Floor: Suite:
Description of Work: ELEC/CHANGE OUT (E) SERVICES PANEL TO 200 AMP
Inspector Area: 4
Legal Description: N TR 4705 LOT 31
Owner: HSU JACK Contractor: OWNER/BLDR
Address: 2100 ARALIA ST Address: HSU JACK
NEWPORT BEACH, CA 92660
Phone: 949-677-7278
Phone:
Con State Lie: O/B
Issued Date:12/02/2020
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
$46.00
0-600V over20OA:
0
$0.00
Over600V or1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL
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
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee :
$0.00
11111111111111111111111111111111111111111111111111111 Electrical Permit: E2020-0685
z 0 z 0 e 6 e 5 Project No : 1964-2020
Inspection Requests Phone (949)644-3255
Code Edit: 2019
U
0
Worker's Compensation Insurance
P 1
Carrier :
Policy No:
�l
Expire
c!)
FEES
Motors/Transformers (HP/KVA)
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
0
$0.00
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$37.00
Supplemental Fee:
$0.00
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.
IWNER-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 pfaced rext to the applicable item(s)
'action 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
ie 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
'rofessions 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
of more than five hundred dollars ($500).
7 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) 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
WRwements 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
n rov)d for the purpose of sale).
leI, s 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
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:
ly my signature below I acknowledge that, except for my pers n I residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal[)
ell a structure that I have built as an owner -builder if it has t b an construc d in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 044 of the Business and
'rofessions Code, is available upon request whe t ap I do is submitt d e following Web site:http://www.leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Agent - Da
.ICENSED CONTRACTOR'S DECLARATI
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 Professions Code, and my license is in full force
nd effect.
icense Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: 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
DST 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:
I 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 IN
erformance of the work for which this permit is issued. Policy No.
]I have 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' compensatior
isurance carrier and policy number are:
:arrier Policy Number Expiration Date
lame of Agent Phone #
certify that, in the performance of he ark for whit 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 agree
1a , if I should become s bject to t wo ers' comp tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr vvisw9s.
signature of Applicant DfWy�% ZiC,
)ECLARATION REG NG N U O NCY
hereby affirm under tenalty of perjury that the Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
tinder'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 pro ided s correct.
I agree to comply with all applicable city and county ordi nce and state Is relating to building construction.
I authorize representatives of this city or county to ter e a ve-identifie operty for ins e ' n purposes.-
:ignature of Property Owner or Authorized Agent rint Property Owner's or Authorized Agent's Name
ACTION DATE r BY ECLARATION OFCOMPLIANCE WITH CODE OF FOR OFFICE USEDNLY
crOER40 RECULARPNF PART 61 OF TITLE40 AND
PERMITEXPMED —I AQMD RULE 14C3.
❑ / SJBMI TED'SEESTOE NO nFtCATiON TO:
PERMITCANCELLED ^ ❑ EPA
PERMITEXTENDED 2
❑ AQMD
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PERMIT FINAL FPOPOSEO DEMO'1 R(1N.
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