HomeMy WebLinkAboutE2022-0187 - PermitsCity of Newport Beach - Building Division
t 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 660 NEWPORT CENTER DR Bldg: 1 Floor: 9 Suite: 940
Description of Work: COMM 9 OUTLETS AND 8 LOW VOLTAGE
Inspector Area: 7
Legal Description: P.M. 295-33 PAR 6 POR OF PAR
Owner: IRVINE CO
Contractor:
Address: 4343 VON KARMAN AVE #350
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Con State Lic:
Issued Date:03/23/2022
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
11�111 11111111111111111111111111111111111111111111 11111 Electrical Permit: E2022-0187
Project No : 0767-2022
Inspection Requests Phone (949)644-3255
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Code Edit: 2019
SASCO Worker's Compensation Insurance •'
2750 MOORE AVENUE Carrier: TRAVELERS PROPERTY
FULLERTON CA 92833 Policy No: UNON1616082025K • .
714-870-0217 Expire : 05/01/2022
125897
05/31/2023 '
BT30046326
02/28/2023 - -
FEES
New Construction
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
9
$15.75
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
0
$0.00
Low Voltage
8
$8.00
50 to 100 HP/KW/KVA:
0
$0.00
0
$0.00
Service
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$20.66
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$38.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL Fee
: $82.41
Plan Check Fee : $0.00
Fee Due at Permit Issuance :
$82.41
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday- Friday7:00 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 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 Iicensure 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).
1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or C_) 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 Iicensure under the Contractors' State License Law for the following reason:
By my signature oPlow 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 structu:L :hat 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.gov/calaw.html.
Sigrature of Pi orI .rty 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 wi Se lion 7000) of Division 3 of the Business and ofe sio C nd my license is in full force
and effect. % Z Z Z
1. icer.3e Class - License No Date Contractor Signature
(WORKERSCOMPENSATION DECLARATION
iWARNII,G: 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
.JJST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm uncle, 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
oerfurrrance of we wo-k 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
of Agent
Date
I certify that, in the performance of t or or h thi ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre
that, if I should become.;pbject to the IS s ion revisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant /\ Date '2 > A �—
DECLARATION REGAYDINTRUCTION 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 ( ec' n 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.
I have read this application and the information I have rev ded 's correct.
I agree to comply with all applicable city and county rdina and((���te laws relating to building construction. �(�)
I authorize representatives of this city or coun t an r e a QentTted•{xaperty for inspection purposes.
Signature of Property Owner or Authorized Agent _ Print Property Owners or Authorized Agent's Name \ �1 Date
AC77ON
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE 115EONLY
FEDERAL REGULATIONS PART 61 OF TIRE 40 AND
AQMD RULE 140.
PERMITEXPIRED
❑ I SUBMITTED ASBESTOS N077FICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS N077RCA71ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
- Z
CERTIFICATE OF
SIGNATURE:
OCCL'PANCYISSU€D
Z