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HomeMy WebLinkAboutE2019-0101 - PermitsCity of Newport Beach - Building Division *E2019-0101* Electrical Permit: E2019-0101 100 Civic Center Drive Newport Beach, CA 92660 Permit Counter Phone Project NO (949)644-3288 n�exrswaes. - .Inspection Requests Phone(949)644-3255. Job Address: 1 (PM) CAMBRIA DR Bldg: 1 Floor: Suite: Description of Work: ELEC/ REPLACE PEDESTAL METER "CHANGE OF CONTRACTOR*" Inspector Area: 4 Code Edit 2016, Legal Description: Owner: REGENT ASSOC Contractor: KORE ELECTRIC Worker's Compensation Insurance Address: 274G DAVE #200 Address: 3175 CALLE OLA VERDE Carrier: STATE COMP S.?T TA92705 SAN CLEMENTE CA 92673 Policy No: 9210652 Phone: 14.634-0611 Phone: 949-793-3262 Expire 03/01/2020 Con State Lic: 745565 Issued Date: 2/22/2019 Lic Expire: 02/29/2020 Bus tic: BT30066180 Processed By: LicExp Date: 02/29/2020 .. ° ...o° . FEES . . e. 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 SU.w 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 a °.'0 ;B07UUi Lov✓ Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 , `: .. °0 $1I°.UtP Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record MgmtFee: $0.00 0-600V up to 20OA: 0 $0,00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 ` $0.00 Piggy Backrremp 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 Feer $35.00 . 0/H to U/G ' 0 $0.00 Additional Fee: $0.00'- Supplemental Fee: $0.00 TOTAL Fee: $35.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $35.00 i - 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. /NER-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) ction 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 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 fessions 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 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, ;iness 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 irovements 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). 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 illy 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: 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 legal) 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 fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Property Owner or Authorized Agent Date TENSED CONTRACTOR'S DECLARATION :reby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S5clion 7000) of Division 3 of the Business and Profe 'ons Code, and -my license is in full force irise Class • • 0 License No % �5�(p S Date r� y ��Contractor Signature )RKl%RS' C&MPENSATION DECLARATION WIR13t VAILURE T5 BOOS 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 IT OF dbMPENSAj10N, DAMAGES AS PROVIDED FOR IN SECTION 5703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hgb?affirm under penalty of perjury one of the following declarations: •. I have and wilf ali ttain 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 f�rm`aace of A work4or which this permit is issued. Policy No. 'I aNy and wiu fna'A4in 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 compensation 1r zcarrier anel policy number are; �Ier Policy Number Expiration Date ne of Agent «.+ Phone # "#W)6that, in the performance 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' compensationlaws of California, and agree J4 gflould bQdb? w subject to the wort ' co pensation provisio of Section 3700 of the Labor Code, I shall forthwith comply with those provisions:" nature of Applican[NI/ / Dat CLARATION REGA DING CONSTRUCTION LENDING AGENCY ireby affirm under pe alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued action 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 behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction.. , I authorize representatives of this city or cou_nty`i 5n r the abo Ild-en�tificed property for.�inspection purposes.^ A /, nature of Property Owner or Authorized Agents-' F �� --u Print Property Owner's or Authorized Agent's Name�C J ACTION DATE BY DECLARATION OF COMPLIANCEWITN CODEOF ..FOR OFFICE USEONLY FEDERAL REGULATIONSPART 61 OFT17LE40AND AQMDRULE1403. PERMITEXP/RE0 ❑ 1 SUBMITTED ASBESTOS NO71FICATION TD. ❑ EPA - ❑ AQMD: ❑ ASBESTOS NOTIFICAROYIS NOT APPLICABLE TO PROPOSEDDEMOLITION I PERMIT CANCELLED �P€RMITEKFENDED PERMIT FINAL CERTIFICATE OF SIGNATURE: IOCCUPANCYISSUED