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Home My WebLink AboutE2019-0109 - PermitsCity of Newport Beach - Building Division 11�IIJill IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIilIII 11 Electrical Permit: E2019-0109 o 100 Civic Center Drive, Newport Beach, CA 92660 2 0 1 9 0 1 0 9 Project No : 0652-2018 Permit Counter Phone (949)644-3288 ) Inspection Requests Phone (949)644-3255 Job Address: 115 29TH ST Bldg: 1 Floor: Suite: Description of Work: ELEC - PIGGY BACK METER (X2018-0779) Inspector Area: 1 Legal Description: NEWPORT BEACH CITY BILK 29 LOT 28 Owner:, 115 29TH STREET LLC Contractor: Address: 112 30TH ST Address: NEWPORT BEACH, CA 92663 •omm Phone: Phone: Receptacle/Switch/Outlets Con State Lie: Issued Date:02/26/2019 Lie Expire: 0 Bus Lie: Processed By: —Lie Exp Date: New Construction Residential Multi -Family: 0 1-2 Family: 0 Service 0-600V up to 20OA: 0 0-600V over 2@@A:- 0 d'ver 600V or 1<060A 0 °O`/Wto U/G m o o a o e 0 m m ® m .a4om c FEES •omm 0 Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) m m e 0 o •• o mo 0 mG o a m m 0 $0.00 mo 0 m o $0.00 e �o ®`000< 6 $0.00 10 to 50 HP/KW/KVA: �aoo $0.00 m Low Voltage comm BURKHART BROTHERS CONSTR 130 MCCORMICK AVE #107 COSTA MESA, CA 92626 949-375-6735 905510 10/31/2019 ST30026859 03/31/2019 Code Edit: 2016 Worker's Compensation Insurance Carrier: SECURITY NAT Policy No: SWC1228381 Expire : 02/01/2020 Temp Underground: 0 $0.00' Sub Panel: FEES $0.00'. 0 Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) 0 Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Signs Over 100 HP/KW/KVA: 0 $0.00 $0.00 Branch Circuit: 0 $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 1 $38.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 $0.00 Additional Fee: $0.00 Temp Underground: 0 $0.00' Sub Panel: 0 $0.00'. 0 $0.00 0 $0.00' Record Mgmt Feer $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $0.00 Supplemental Fee: $10.00 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. S IWNER-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) lection 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 fora 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). 3 1, 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 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: iy 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 leyally 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 Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION 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(?salons Code, and icen in full force is effect. 2 Contractor Si icense Class License No Date gnature VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL 700,0001, IN ADDITION TO THE OST 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: 7 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 tht Kormance of the work for which this permit is issued. Policy No. ) ve 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 Ira ce carrier and policy number are: r Policy Number Expiration Date is of Agent Phone # certify that, in the performance of the work forw�F�+' his permit is issued, I shall not em toy any person in any manner so as to become subject to the workers' compensation laws of California, and agrer , if I should become sutftt to the workers' cor2ee" at on'97ovisions of Se of the Labor Code, I shall forthwith comply with those provisions. t I rature of Applicant I Date 2 'ZAP j :LARATION REG DING CONSTRUCTI L DI AGENCY reby affirm under penalty of perjury that there construction lending agency for the performance of the work for which this permit is issued action 3097, Civil Code). .... der's Name a Lender's Address Try signature below, I certify to each of the following: ° ° ...... I am the property owner or authorized to act on the property owners behalf. ...... . ° 1 have read this application and the information I have provided is correct. L ° ° :. ° ; • o I agree to comply with all applicable city and coun ordinances an ate laws relating to building construction. v I authorize representatives of this city or county}o ter th ab e= ntifted propert r -inspection purposes. /' 2' 2 (� ° • ~°Date •' ° i y iature of Property Owner or Authorized Agent / Print Property Owner's or Authorized Agent's Name "' ACTION DATE BY DECLARATION OF COMPLiANCEtMTHCODEOF FOR DFRC€US A LY. ° FEDERAL REGULATIONSPART 61 OFTITLE40AND AQMD RULE 1403. • • ' . ° • ° PERMIT€XPIRED ❑ I SUBMITTEDASBESTOS N611FICATIOiV TO: ❑ EPA ❑ AQMD , •. • .•••.o '••.• . PERMITCANCEtLED PERMITEXTEND€D . ASBESTOS RDNIS NOTAPPLCABLE TO PROPOSED DEMOLITION. .... L LvP€RMITFINAL �0 CERURCATEOF SIGNATURE. OCCUPANCYISSDEED