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Home My WebLink AboutE2014-0543 - PermitsCity of Newport Beach - Building Division of 9 100 Civic Center Drive, Newport Beach, CA 92660 ' N Permit Counter Phone (949)644-3288 O n+[rroaR`tr Job Address: 41 GANNET LN Bldg: 1 Floor: Suite: Description of Work: ELEC/ELECTRIC VEHICLE CHARGING STATION Inspector Area: 3 Legal Description: N TR 12529 LOT 23 Owner: QUATTROCIOCCHISTEVE Address: 41 GANNET NEW PO BEACH, CA 92660 Phone: Issued Date:1 Processed By: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 AL Fee: $47.04 Contractor: MCBRIDE ELECTRIC Address: 1278 MONTALVO WAY PALM SPRINGS CA 92262 Phone: 619-857-9594 Con State Lic: 203019 Lic Expire: 03/31/2016 Bus Lic: BT30044483 Lic Exp Date: 08/31/2015 Receptacle/Switch/Outlets Receptacles/Outlets: 1 $1.00 Fixtures: 0 $0.00 Sep Circuits: 1 $6.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Electrical Permit: E2014-0543 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2013 .. Worker's Compensation Insurance Carrier: TRAVELERS Policy No: WC2Z91437157093 Expire: 04/01/2015 FEES Motors/Transformers (HP/KVA) 0to1 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 Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: 0 0 0 0 Check Fee: $47.04 Fee Due at Permit Issuance : $0.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION $0.00 $0.00 $0.00 $0.00 $0.00 $5.04 $0.00 $35.00 $0.00 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 is 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). 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, lusiness 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 nprovements 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 nproved 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 pply 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 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 legalll ell 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 'rofessions Cqd::. 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 Cwner or Authorized Agent Date 'CEN3ED CONTRACTOR'S DECLARATION hereby affirm under p.^nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profe lions Code, and my license is in full force lid efrect . iceisa Class_,__ G1tt O License No 0,0 Oate 111711 y tr tor Signature vORKERS' COMPENSATION DECLARATION 'ARNAG: FAILURR TO SFgURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU&IECT' N EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ON H DRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE rFT COMPEN7AT'ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. he'riry affirm under penalty of perjury one of the following declarations: age 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 thi §rfo � nce oftihe won( for which this permit is issued. Policy No. A haP. and will �aintain 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 is lice carrier anal onlicy number are: is of Agent certify that, in the p, . if I should become of Applicant Policy Number I— 000 ..i~L/IS Expiration Date 1Q4%/Z� Phone # 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 he workers' compe:Wation provisjRns of Section 3700 of the Labor Code, I shall forthwith comply with those proyt'sions. DECLARATION REGA I CONSTRUCTION LNDING AGENCY /�'� 7 I hereby affirm under n y of perjury that there is a construction lending agency for the performance of the work for which this permit is i sued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature belo , 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 provided is correct. J ree to comply with all applicable city and county o finances and state laws relating to building construction. thorize representatives of this city or countytoe er the abov - entified rop rt for i purposes.//��re of Property Owner or Authorized Agent perty Owner's or Authorized Agent's Name J 0. � (..4-1,&'-.A, ACTION DATE RY DE RATION OF COMPLIANCE K9TN CODEOF FOR OFFICE EONLY FEDE L REGULATIONS PART 61 OFTTTLE40AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMTTEDASBESTOS N071FICATIONTO: ❑ EPA ❑ AQMO PERMITCANCELLED PERMIT EXTENDED PROPOSED DEMOLITION. ASBESTOS TIONtS NOT APPLICABLE TO PERMIT FINAL I I/Z 14 T` .y CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: