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HomeMy WebLinkAboutE2022-0165 - Permits„awPb�. City of Newport Beach - Building Division ' >• 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �'�L iYi14N,` Job Address: 567 SAN NICOLAS DR Bldg: 1 Floor: Suite: Description of Work: COMM ELEC/REPLACE (E) SERVICE PANEL @ PARKING LOT Inspector Area: Legal Description: IRVINE SUB LOT ELK 93 POR OF BILK Owner: AMALFI INVESTMENTS GP Contractor: Address: PO BOX 7099 Address: NEWPORT BEACH, CA 92658 Phone: Phone: Con State Lic: Issued Date:03/17/2022 Lic Expire: Bus Lic: Processed By:C+r6� Lic Exp Date: IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2022-0165 E 2 0 2 2 9 1 6 5 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 DYNAMIC ELECTRICAL SOLUTIONS CO Worker's Compensation Insurance 16835 ALGONQUIN ST, STE 164 Carrier: PREFERRED EMPLOYERS INS HUNTINGTON BEACH CA 92649 Policy No: WKN1534178 714.907-3325 Expire : 04/08/2022 978307 01/31/2023 BT30073547 11/30/2022 U LA LL (J) z FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 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 0 $0.00 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 200A: 1 $47.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 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 : $85.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $85.00 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 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 L) 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 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 licensure 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 Iegall 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.gov/calaw.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 Pro s o Code, and my license is in full force and effect. License Class License No Date Lt, Contractor Signatu 'r WORKERS' COMPENSATION DECLARATION IV WARNING: 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. I 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 perforwrice of the work for which this permit is issued. Policy No. and will rilKitain 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 an pcy number arC Expiration Date le of Agent ��rG certify that, in the performance if I should become subject to of Applicant for which this permit i5 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions�. Date > 3/17/ZI— IECLARATION REGARDING qP14131RILICTION LENDING AGENCY hereby affirm under. iaity of that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name tepry Lender's Address y my signature below, I certify t 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 provide is correct. agree to comply with all applicable city and county ordinanc and state laws relating to building construction. I authorize representatives of this city or county o enter. the o identifie roperty, for inspection purposes. 11�� l k signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Yih ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF r FOR OFFICE FE9ER41. REGUL A TIONS PART 61 OF TITLE40 AND AQh.D,RULE 1407. ❑ I SUSMITTECASBESTOS NOTIFICATION TO:. ❑ FPA ❑ AQMD PERMIT EXPIRED PERMITCANCELLED PERMITEXTENDED ASBESTOS NO nFICARON IS NOT APPLICABLE TO PROPOFEDDEMOUTION. SIGNATURE: - PERMIT FINAL S //- Z 2 sr"e Z CERTIFICATEOF OCCUPANCYISSUED