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HomeMy WebLinkAboutE2019-0631 - PermitsCity of Newport Beach - Building Division��IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII Ill it Electrical Permit: E2019-0631 P4. 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 6 3 1 Project No :2538-2018 �. ; Permit Counter Phone (949)644-3288 0"'; FEES rra�4 New Construction Inspection Requests Phone (949)644-3255. Job Address: 2201 ALTA VISTA DR Bldg: 1 Floor: Suite: Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Description of Work: ELEC -4 OUTDOOR RECEPTACLES Inspector Area: 8 Code Edit: 2016 Legal Description:N TR 4705 LOT 79 4 $4.00 Owner: WEBB CHRIS Contractor: UNITED CONTRACTORS Worker's Compensation Insurance Address: 2201 ALTA VISTA DR Address: 10725 ELLIS AVE #D Carrier: STATE FUND NEWPORT BEACH, CA 92660 FOUNTAIN VALLEY CA 92708 Policy No: 9119462 Phone: 858-735-3207 Phone: 801-792-7417 Expire : 12/06/2019 Con State Lie: 94900$ $0.00 Issued Date:09/17/2019 r Lie Expire: 06/30/2020 $0.00 Bus Lie: BT30053869 $0.00 C)kt' Processed By: Lie Exp Date: 02/29/2020 $0.00 10 to 50 HP/KW/KVA: 0 INSPECTOR 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 frglV 4.,Po a.m. t9 6ZQq p.m.. m m CO O G CO C' G C O 0o O 9 C OC U 6© 00 O 00 0 0 0 0 O G m00 O O O mC mGG O O C O CC C m0 C mm 0 mm mmm m m em mmm mmm FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 4 $4.00 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 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 0-600V 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 Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 100oA: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 TOTAL Fee: $39.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $39.00 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 frglV 4.,Po a.m. t9 6ZQq p.m.. m m CO O G CO C' G C O 0o O 9 C OC U 6© 00 O 00 0 0 0 0 O G m00 O O O mC mGG O O C O CC C m0 C mm 0 mm mmm m m em mmm mmm 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 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 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 L) 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 improved 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 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 I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally 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 Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I 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 Professions Code, and my license is in full force and effect. License Class License No Da 9 /% Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE INDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 th 5erformance of the work for which this permit is issued. Policy No. ave 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' compensatio insur nce carrier and policy number are: ler Policy Number Expiration Date Name of Agent Phone # 111 certify that, 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' compensation laws of California, and ogre that, if I should become subject to th ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applic DECLARATION REG ING CORSTRUCTION LENDING AGENCY I 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 (SL ion 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 owners 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 ands ate laws relating to building construction. I authorize representatives of this city or county toe a-' Ified property for inspection purposes. A Signature of Property Owner or Authorized Print Property Owner's or Authorized A ent's Name F/Y Dale _( ACT/ON DATE � BY DECLARATION OF COMFUANCEi4riFtf CDDEOF FOR OFFICE OSEONLY • • • • • • • • • • FEDERAL REGULATIONS PART 610FT17LE40AND PERMITEXFfREU :•: .•: . • : .•� AQM6 RULE7403. D f St16trAfTTEOASBESTOS NOTtFlCATtON TO., PERA4ITCANCELIED • • • • • • © EFA PERM7TEXTENDEO 13 Af2MD © ASBESTOS NOfiRCARONlS NOTAPPLICABLE TO PERfiRtT.FtNAt • • • • • • • • • • • PROPOSEOOE1lfOf1TlON CERTIFICATE OF QCCOFANCY$SSUED • • • • • • • • SIGNATURE.,