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Home My WebLink AboutE2019-0406 - PermitsCity of Newport Beach - Building Division 11111111111p111111111111111111p11111111p11111111Electrical Permit : E2019-0406 (4) 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 4 0 6 Project No : 2631-2017 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 2501 (EV) BLACKTHORN ST Bldg: 1 Floor: Suite: Description of Work: ELEC - 200 AMP METER FOR EV CHARGER Inspector Area: 8 Code Edit: 2016 Legal Description: N TR 4893 LOT 84 Owner: ANTOYAN ALLEN & TONI TRUST Contractor: OWNER/BLDR Worker's Compensation Insurance Address: 2501 BLACKTHORN ST Address: Carrier: NEWPORT BEACH, CA 92660 - Policy No: Phone: 714-325-6757 Phone: Expire Con State Lie: O/B Issued Date:06/13/2019 Lie Expire: Bus Lie: Processed °y:_ Lie Exp Date: Y FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) 0 $0.00 Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: Multi-Familv: 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 0-6J0V up t0 200A: 1 $43,00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 0-600V ove, 2UUA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $35.00 Over 600V cr 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental Fee: TOTAL Fee : $78.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $78.00 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. 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 he 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 lot 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, 3usiness 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 mprovements 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 mproved for the purpose of sale). J 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 I 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). am exempt from licensure under the Contractors' State Wcense La or the following reason: 3y y signature below I acknowledge that, except for my pe o I rest ce ! which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal, a structure that I have built as an owner -builder if it he en ru its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Bu iness and 'rofessions Code, is available upon request when his ap is the following Web site:http://www.leginfo.ca.gov/calaw.html.IA Signature of Property Owner or Authorized Ag -ICENSED CONTRACTOR'S DECLARA hereby affirm under penalty of perjury that I am licensed under provisions of hapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force Ind effect. .icense Class License No Date Contractor Signature PORKERS' 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 it, 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' compensrtiol lsurance carrier and policy number are: Policy Number Date of Agent Phone # ce ify that, in the performa4tk for Ich t ' it is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of(.aiitrnia, and should become subjects' c visions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.nature of Applicant DateCLARATION REGAR LEWD1113 AGENCY �reby affirm under penalty of perjury that there is a c struction lending agency for the performance of the work for which this permit is issued (Sectio 3097, Civil Code). Ider'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 behal I have read this application and the information I have pro e s correc . I agree to comply with all applicable city and county Ord! and at aws I ting to building construction. I authorize representatives of this city or county to ante ve-id for inspection purposes. nature of Property Owner or Authorized Age. Print Property Owner's or Authorized Agent's NamV Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODEOF FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1403. ❑ I SUBMITTED ASBESTOS NODFICATION TO: ❑ EPA ❑ AOMD ❑ ASBESTOS NO17FIC117ONIS NOT APPLICABLE TO PROPOSED DEMOLITION, SIGNATURE: FOR OFFICE USE ONLY PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMITFINAL CERTIF{CATEOF OCCUPANCYISSUED