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HomeMy WebLinkAboutE2018-0749 - Permits,t, City of Newport Beach - Building Division I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2018-0749 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 8 0 7 4 9 Project No: 0964-2018 ;^ Permit Counter Phone (949)644-3288 9s7 aP ���lYO$�b Inspection Requests Phone (949)644-3255 Job Address: 20141 BAY VIEW AVE Bldg: 1 Floor: Suite: Description of Work: ELEC -100 AMP SUBPANEL Inspector Area: 8 Legal Description: N TR 1507 LOT 7 Owner: CROCKETT GARY W & SYLVIE Contractor: N I V CONSTRUCTION Address: 20141 BAY VIEW AVE Address: 150 N AVENIDA SEGOVIA NEWPORT BEACH, CA 92660 Fixtures: ANAHEIM CA 92808 Phone: Phone: 949-606-6895 0 Con State Lic: 929624 Issued Date:11/19/2018 j Lic Expire: 03/31/2019 ® Bus Lic: BT30044187 Processed By: Lic Exp Date: 07/31/2019 ke.%%Constrr(,dt(6jf , JR,ppl1kritial ° ° ° wlulti-F,amily: ° Ia�aenilY: ° ° (7-6QQ,V up to 200A: ° 0o600°V over ZQO :° Pvet @OOV or 1000A9 OIN tp'U/G ° °TOTAL Fee: $61.00 FEES Code Edit: 2016 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9227217 Expire : Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 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 $0.00 Signs Plan Check 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 : e at Permit Issuance: $0.00 °TOTAL Fee: $61.00 FEES Code Edit: 2016 Worker's Compensation Insurance Carrier: STATE FUND Policy No: 9227217 Expire : Motors/Transformers (HP/KVA) 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: 0 $0.00 Plan Check Fee : Temp Underground: 0 $0.00 Sub Panel: 1 $26.00 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 e at Permit Issuance: $61.00 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. IWNER-BUILDER DECLARATION 1 hereby affirm under penalty of perjury that 1 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 items) 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 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 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 for a 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 (_) 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 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). 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 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). 1 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 legally 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 Professions Code, and my license is in full force nd effect. / icense Class License No Date Contractor Signature/d/C.c-®— 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 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: 1 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 thi elfprmance of the work for which this permit is issued. Policy No. LI,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' compensatior ance carrier and policy number are: •• :arrier Policy Number Expiration Date . . . •. ° ° lame of Agent Phone# ••0000 1 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 laiA'b1 CAlifornie: anq ai3rel rat, if I should become subject to the orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n • ...... ignature of 'ECLARATION REGI�t�ING CONSTRUCTION LENDING AGENCY 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). Ender's Name Lender's Address ...... ° y 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 and state laws relating to building construction. • • : • ° ° ° I authorize representatives of this city or county to enteytt a above -identified property for inspection purposes. II ACTION DATE BY I I DECLARATIONOF COMPLIANCE WITH CODEOF A.rt I ' FOR OFFICE USEONLY PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED 0 I SUOMTFEDASDESTOS NO71FICATIONTOr 0 EPA 0 AQMD 0 ASBESTOS M017RC4170MIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: