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HomeMy WebLinkAboutE2017-0167 - Permits�wuo City of Newport Beach - Building Division *E2017-0167* Electrical Permit: E2017=0167 100 Civic Center Drive, Newport Beach, CA 92660 Project NO Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 �rrnP'� Job Address: 1936 SANTIAGO DR Bldg: 1 Floor: Suite: Description of Work ELEC-S,EVI✓p9MEL�4RE 290AMt �'�¢" '� ••4 "•"° t �a.ma ,, wR• e e n 'Zv ®t66G0 1-1 applicable: Inspector Area: $ --�— Code Edit: 2016 f ; • i )i "j"•r° NTR*2� y 100% refur, 80% or E Legal Description: �e ek `F •tle�„ o Owner: EASTHAOJA S lr 4Tontrk$ ` rl BLUplyl{Vh�E4Et0 )r.:li7g to W{ICril: wnrkarcCompensationlnsurance a+••®• Address: 1936SANI —,! R- c A?cdress:°n' " I G�AW3�T Carrier: WC EXEMPT • •••" NEWPOR* BE4 92660 NORWALK CA 90650 Policy No: (NO EMPLOYEES) e. ® • Phone: 949-642-5059 hh a 7 582374I AMI v� Expire: o®®o, r��3fE yn t�Sti3�;e LIG' i y$@7657 1{ Issued Date:04/13/2018 W, xp�ir 115%3 /20f8 J u�w ' B30�587�'r s . • e Processed By: Lic Exp Date: 04/30/2018 New Construction s =, ewitch/Outlets Mot�%/TG r{dtngQ`(�(IE/Ii�A) Residential 1 �rlRe�6c 04 fzed ba utlets: 0 $0.00 0 to HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 �,0.q0• 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: tOs �N$0.00, WfS61f� d" ' f 0 j tLaiGDLE�% 10 to 5n HP/K1NL NIA n $ g._—_.-.-. 0 $0.00 { L e 0 $0.00 50 to 100 HP/KW/KVA 0 $0.0 0 $0.00 Service Signs fla Record Mgmt Fee: $0.00 0-600V up to 200A 1 -$41,00-- BrartctrG'ircatt. 0 00 Plan Check Fee: $0.00 0-600V over 20OA •:n,.p r_ $p,fl0 � Ear d,olrcOffi. " "" _ piggy Back/Temp Power 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $33.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 TOTAL Fee: $74.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $74.00 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. 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 aad'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). ❑ 1, 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 iOpro'velnents Eta %Q iptended 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 Mb &H for the purpose of sale). n J, abowner "oetR %operty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not aApt)r'tb-an owner Sf property who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors State License Law). a 1 %%exempj;ro"licensure under the Contractors' State License Law for the following reason 9t "%IgnaturJbelovjf 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 Iegalh sell "ructure that I have built as an'owner builder if it has not been constructed In its entirety by licensed contractorsA underatanq that a copy of the applicable law, Section 7044 of the Business and p5olesslons Cod®,.is OQailable upon request wheh'tliis applicationis submitteilbr"at the following WeDsite:http.//www.leginfo ca gov/calaw.html. $i9 atYre of Property OwnerIor Authorized Agent Date GLCEg3ED CONTRACTOR'S DECLARATION hereby affirm undev penalty. of penury that Ilan licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business4NDRRED ons Co , and y license is in f II force ORdoffect. .... _ w ��, _ (� Cicense'Class - License No _ '� Date Li •hJ,� ) Contractor -Signature NORKERS' 110-;; •NSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONAND DOLLS (8100,0001, IN ADDITION TO THE :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE'LABOR CODE, INTEREST, AND'AirTORNEY'S FEES; hereby affirm under penalty of perjury one ofdhe following declarations - - I have and will maintain::a certificate.. of.consent to-self-Insure_'':for, workers'. compensation, Issued by _the erformance of the work for which this permit is issued. Pohcy'No.-- ]I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, Isurance carrier and policy number are: ,arrigir.. Policy. Number We if Agent Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for for the performance of the work for which this permit is issued. My workers' ce ify that, in the performance o he wor 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 agre the I should become subject t worke ' comji tion provi"sio ' ' of Section 3700 of the Labor Code I shill 7orit1with eomplywjth those provisio s. Signature of Applicant Dabe! Y 113 I DECLARATION REG RDI G ONST CTION L N G ENCY I hereby affirm under penalt f perju hat -there is onstruction lending agency for the performance'of'the work for which 'this permit-isAssued'(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,pri the, pfopertyowppr�.,behaIf. I have read this application and the information I have provided is C Tect. I agree to comply with all applicable city and county or n nces a 15 sta a laws relating to building construction. I authorize representatives of this city or county to to he ab e-ide t proper for inspection purposes. �f Sionature of Property Owner or Authorized Agent �� Print Property Owner's or Authorized Agent's Name/-- � r &Uj6L Datel.� ACTION DATE DECLARATION OF COMPLIANCE WITH CODE OF FOR OrFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND `` t� 1� �I 00 VLCC` IIS'lam, PERMIT EXPIRED f� Q'/ 17AQMDRULE1403. 0- ISUBMITTEDASBESTOSNOTIFICATRONTO: 13 EPAAQM I ©� PERMITCANCELLED V PERMITEXTENDED 0 ASBESTOS NOTIHCARONIS NOTAPPLICABLE TO PROPOSED DEMOLITION. 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