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HomeMy WebLinkAboutE2019-0467 - PermitsCity of Newport Beach - Building DivisionIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII Electrical Permit: E2019-0467 0 100 Civic Center Drive; Newport Beach CA 92660 IIII E 2 0 1 9 0 4 6 7 III .project No :2483-2017 'k Permit Counter Phone (949)644-3288 ire <.nx° Inspection Requests Phone (949)644-3255 Job Address: 2407 BUCKEYE ST Bldg: 1 Floor: Suite: Description of Work: ELEC/OUTLETS AT BBQ Inspector Area: 8 Code Edit: 2016 Legal Description: N TR 4893 LOT 101 VeEC1R Owner: ZEtRICK Contractor: KESKY EDDIE GENERAL CONTRACTOR INC Worker's Compensation Insurance .... Address: Address: 10841 BLOOMFIELD STREET Carrier: REDWOOD FIRE 92660 LOSALAMITOSCA90720 Policy No:EDWC10687Phone: Phone; 562-795-5755 Expire 01/01/2020 Con State Lie: 768265Issued Date. Lie Expire: 09/30/2019 Bus Liie: ST30057336Processed By:Lie Exp Dater :11/30/2019 ° . ...c°. • . ° FEES.. New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 2 $2.00 0 to 1 HP/KW/KVA; 0 $0.00 Temp Underground: °.=°0° $0.00 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 5D HP/KW/KVA: 0 $0.00 b $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 0-600V up to 2ODA: 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.Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1o00A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 issuance Fee: $35.00 O/H to JIG 0 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 TOTAL Fee: $37.00 Plan Check Fee: $37.00 Fee Due at Permit Issuance: $0.00 PERMITS EXPIRE 980 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION - - - Construction Hours: Monday - Friday 7:00 a.m. to 6:36 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 iterl(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 Im roved for the purpose of sale). 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 not apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) sell 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 Professions 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 Prop�errty�Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION �ereb affirm undef penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with. Section 7000) of Division 3 of the Business and Professions e, a d m license is in full force end effaot. , • • • / Lipengp Class ,-- - ,6 License No /O eL6� - Date ?-Ib X Contractor Signature SIfISRARS'cCO IIRENSATION DECLARATION NpRNI*: FAILUry�R Q,,jjSF��.1RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH SAND DOLLARS ($100,OOD), IN ADDITION TO THE GGSY`O•COMP@fS�':TIOIS,=IAMAGES AS PROVIDED FOR IN SECTION 37oS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . herd y affirm°uji4er penalty of perjury one of the following declarations: s.{Ir, fj2ve rtB Lv'I!I •rnalntain acertificate 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 Vro - � nce of tira1aro�tk for which this permit is issued. Policy No. and yr)rWpip!tain 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' carrIGr,;yLd.0bIIcy number are: T• •• • Policy Number - Expiration Date ©- P ocGorid I certlly that, In the performance of thew o ich 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 t1a(; Sf9 Should bccnme aubject tot a ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 000 O G C pGBG Signature of Appllcan Dater DECLARATION REGARDING CONSTRUVIbN LENDING AGENCY I hereby affirm under penalty of. perjury t there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name - - Lender's Address By 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 COLloct I agree to comply with all applicable city and county ordinances s laws relating to building construction. I authorize representatives of this city or county to an a a- entified property for inspection purposes. 7-/0 Signature of Property Owner or Authorized AgentNP) Property Owner's or Authorized Agent s Name ` ' %`^ Dat ,. ACTION DATE 81*' . DECLARATION OF COMPLUANCEWUTUICODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONSPARTof OFT17LE4OAND AQMORULE14O3. PERMITEXPIRED. © I SUBMITTEDASBESTOS NOTIFICATION TO: Q EPA ©. AQMD PERN41TCANCELLED PERMITEXTENDED [3 ASBESTOS NODRCA170MISNOT APPLICABLE TO PROPOSED DEMOLITION. PERMITFINAL - 3- 11 CERTIFICATE OF _ SIGNATURE: OCCUPANCYISSU'ED