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Home My WebLink AboutE2019-0394 - Permitse « GltWof 196wpdrYBek8h - Building Division o 100 Civic Center Drive, NL\Fvpc't' ' h, CA 92660 Permit Counter Phone (949)644-3288 e • ° e ¢, w E me° • °e °0 ° co m°° mnm en� Job Address: 1004 BAY FRONT S Bldg: 1 Floor:r Suite: Description of Work: ELEC PIGGY BACK METER (�Uk$ Uoc� Inspector Area: Legal Description: BALBOA ISLAND SEC 2 BLK 5 LOT 3 Owner: WELKERJAY Contractor: Address: 123 LAURELWOOD DR Address: DANVILLE CA 94506 $0.00 Phone: 925-648-0624 Phone: 0 Con State Lic: Issued Date:06/11/2019 Lic Expire: 0 Bus Lic: Processed By: d Lic Exp Date:. ° zNew Construction Wesideratdak � < N&ulti-Family: Family 000 ° `gervice ` D°600V up!e 800A: 0°6oOV over20OA: ,,Over 600V oV1000A: 0/1 -Ito U/C; II IIS IIII ILII IIII IIT IIII IIII 0III3 VIII (IIII III II VITARELLI CONSTRUCTION INC 140 S BAY FRONT NEWPORT BEACH CA 92662 949-677-1872 485418 02/28/2021 BT00011199 08/31/2019 Electrical Permit: E2019-0394 Project No: 0074-2018 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: STATE COMP INS FUND Policy No: 0783123 Expire : 10/01/2019 FEES Receptacle/Switch/Outlets $0.00 Receptacles/Outlets: 0 $0.00 $0.00 Fixtures: 0 $0.00 $0.00 Sep Circuits: 0 $0.00 $0.00 Low Voltage 0 $0.00 Over 100 HP/KW/KVA: Signs $0.00 Issuance Fee: $0.00 Branch Circuit: 0 $0.00 $0.00 Each Add Circuit: 0 $0.00 $0.00 Time Clocks: 0 $0.00 $0.00 Additional Fee : $0.00 Electrical Permit: E2019-0394 Project No: 0074-2018 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: STATE COMP INS FUND Policy No: 0783123 Expire : 10/01/2019 FEES 0 $0.00 Motors/Transformers (HP/KVA) 0 $0.00 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 Back/Temp Power: 0 $0.00 Temp Power Pole: 1 $38.00 Plan Check 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: $0.00 Fee Due at Permit Issuance: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. • )WNER-BUILDER DECLARATION — ; : • • ` • •�• I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmarkl?) I nave placed next to the applicable item(s) Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for ie permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7Qp0) of.Divisiod B,of p Business and 'rofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fpT 1 peFmit subj tds th�`applica$It to a Ivil penalty of of more than five hundred dollars ($500). ;,' : • • : : e' a I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is npt inlZided oPefferr dfor 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 legall) 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 Dat .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 P s s ode, and ense is in full force nd effect. .y icense Class License No Date ( 1 Contractor Signal r VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, 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: III 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 th eff rrmance of the work for which this permit is issued. Policy No. h6ve 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' compensatiol 'sur nce carrier and policy number are: ;r Policy Number Expiration Date OGC ame of Agent Phone # • • •... • 6 11 certify that, in the performance o the owhis4 this permit is is mploy any person in any manner so as to become subject to the workers' compensation laws of California, and hm, tat, if I should become subject tot e ' compens 'on pr ' ns of Section 3700 of the Labor Code, I shall forthwith comply with those proovvissiigna. q� • • • e ionature of ApplicantssuN _..___ D(jn A � / � / • �: ` 000 IECLARATION REGARDING CONSTRHeTM LENUMG AGENCY I / • e e hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). : "`• e ender's Name Lender's Address • ly my signature below, I certify to each of the following: - •• � , • ` I am the property owner or authorized to act on the property wner' behalf. '„� • : , I have read this application and the information I have prov' ed is c Ire • e �,.; I agree to comply with all applicable city and countylordirp ces �' aws relatin to Ing construction. • • • ` ` I authorize representatives of this city or county nter ove- entifi grope r inspection purposes. ` /•. f /f •• signature of Property Owner or Authorized A ent i Print PropertyOwners or Authorized Agent's Na I C,Ac l ate [ ACTION DATE R ULCLARATON OF COMPLIANCE CODE OF FOR OFFFCEUSEOMLY FEDERAL REGULATIONS PART 61 OFTITLE 40AND AQMD RULE 1403. PERMITEXPIRED ❑ t SU131WTTEDASB€5TOS M071F/CATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED P€RMITEXTENDED P❑ROPOSEDDEMOLITIOASBESTOS CN Tff7N/S MOT APPGCABL.E TO PERMITFINAL j2 CERTIRCAT€ OF OCCUPANCYISSUED SIGNATURE: