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Home My WebLink AboutE2019-0405 - Permitsr�N,.r4r City of Newport Beach - Building Division .'` 1 o0 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 c\c. Job Address: 2501 BLACKTHORN ST Bldg: 1 Floor: Suite: Description of Work: ELEC - 200 AMP METER Inspector Area: Legal Oescriptian: 8 N TR 4893 LOT 84 C,wner: ANTOYFAN ALLEN & TONI TRUST Contractor: Aodress: 2501 BLACKTHORN ST Address: NEWrORT BEACH, CA 92660 Phone: 711-32L-6757 Phone: Con State Lic: Issued Date:0611312059 Lic Expire: Bus Lic: Processed By:__ Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 1 $43.00 0-600V over20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee : $78.00 Electrical Permit: E2019-0405 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Project No : 2631-2017 Inspection Requests Phone (949)644-3255 Code Edit: 2016 OWNER/BLDR Worker's Compensation Insurance Carrier : Policy No: 4 Expire : OIB 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 Plan FEES Motors/Transformers (HP/KVA) 0 to 1 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 BackrTemp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Fee : 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: $35.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : $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. 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 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 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 roved for the purpose of sale). 3pAas 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 m exempt from licensure under the Contractors' State License Law for the following reason: 3-y m signature below I acknowledge that, except for my persojInstru ce in which I must have resided for at least one year prior to completion of the improvements covered by this oar n,i;, I cannot legall structure that I have built as an owner -builder if it has at din its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of toe B ioiness and professions Code, is available upon request whe this app 96at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Ag Da A /�� _ -ICENSED CONTRACTOR'S DECLARA 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 fnr^.e and effect. - c .icense Class License No Date Contractor Signature VORKERS' COMPENSATION DECLARATION FARMING: 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 ($10'0,000), IN ADDITION TO THE 'DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 L erformance of the work for which this permit is issued. Policy No. abor Code, 'cr tr ]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: r of Agent Policy Number Expiration Date lidertify that, In the performance th work rwh'ch 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 agre V If I should become ubject to rke tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. mature of Applicant D CLARATION RE DING ONSTRU TION DING AGENCY �c J :reby affirm under penalty of perjury that there construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). lder'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 owner's behalf. I have read this application and the information I have pr Id d is cor t. I agree to comply with all applicable city and county or� es an to I s relating to building construction. I authorize representatives of this city or county Ilo en Nhbov erty for ins ection ur J mature of Property Owner or Authorized A ACTION DATE PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERM�IT FINAL 07 CERTIFICATE OF OCCUPANCYISSUED BY %r P p poses. Print Property Owner's or AQMD RULE 1403. ❑ i SUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS M071RCA 17ONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: %^4_5?gs: y i/d'