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Home My WebLink AboutE2018-0726 - Permits (2)City of Newport Beach - Building Division I I1uIIIIIIIIiiIIIIIIIIIIIIIIIIIIJIIIIIIIII1IIIIIIJill 11Electrical Permit: E2018-0726 4 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 8 0 7 2 6 Project NO : 1708-2018 .F n Permit Counter Phone (949)644-3288 "+4irnw Inspection Requests Phone (949)644-3255 Job Address: 1801 BALBOA BLVD E Bldg: 1 Floor: Suite: Description of Work: ELEC/TEMP. POWER POLE Inspector Area: Legal Description: N TR 518 BLK L LOT 22 Owner: 1801 BALBOA LLC Contractor: Address: 1101 QUAIL ST Address: NEWPORT BEACH, CA 92660 Phone: 949-204-7272 Phone: Con State Lie: Issued Date:11/05/2018 Lie Expire: IM)Lic Bus Lie: Processed By: Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 TOTAL Fee: KLPMINC 12188 CENTRAL AVE #269 CHINO CA 91710 949-246-2923 831751 02/29/2020 BT30065030 11/30/2019 Code Edit: 2016 0000 Worker's Compensation Insurance ° °•° Carrier: NO EMPLOYEES •° . Policy No: • • • ` • Expire °OOOP® 0 ••oe .° 0 PERMITS EXPIRE 980 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. FEES Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 $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 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: ' $0.00 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Backrremp Power: 0 $0.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 1 $38.00 Issuance Fee: $35.00 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 PERMITS EXPIRE 980 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. 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) action 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 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 ,fessions 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 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, ainess 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 )rovements 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 (roved for the turPose of sale). .. I, asowner 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 kyle -en ownepof property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I ap exempt from licensure under the Contractors' State License Law for the following reason: mY sgnature 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 legalh a structure thg664ave 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 jesSpns Co6p1%(Mailable upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi. natere of Property Owner or Authorized Agent Date iBNSED CbUrItACTOR'S DECLARATION ItaWaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000) of Division 3 of the Business and rIf Si s d ,and 1 license is in full force !WWI. nnseClass T:-. License No S �Z 76 ( Date l� Contractor Signature ACa 3f3KERS' COMP2NSATION DECLARATION IMNOFFAILURF� 1q g&� j1RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE :OST OF COMPEN$ATIQN. 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: 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 the erformance of the work for which this permit is issued. Policy No. ]I have 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 Isurance carrier and policy number are: :arrier Policy Number Expiration Date Ip#me of Agent Phone # JI certify that, in the perfor enc oft wor fo which Is 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 agree tat, if I should become subj ct ork s' p ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov' ions. signature of Applicant Dal !!� l o® IECLARATION REG DING CONSTR TION L NDING AG NCY T—�` hereby affirm under penalty of perjury that there is a constr n lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 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 propZ.�e'>,belf. 1 have read this application and the information I have pt1 agree to comply with all applicable city and count ordate la relating to building construction. I authorize representatives of this city or county o n ' property for inspection purposes./�ionature of Prooertv Owner or Authorized ADent `a� Print Prooertv Owner's or Authorized AQent's Name X �-� a oa, ACTION DATE BY LIZ- LA fJVM Vr•LVY%YUHIY4C VV"n UVUC Vt- run vtrf rwe VIVLr FEDERAL REGULATIONS PART 61OF777LE40AND PERM/TEXPIR€D AQMD RULE 1403. _ ❑ f SUBMITTEDASSESTOS M07IFICATION TO: PERMfTCA.NCELLED ❑ EPA PERMITEXTENDED ❑ AQMD 0 ASBESTOS PERMITFINAL ,�� .� Dom- I�- , PROPOSED DEMOUTIONAONISNOTAPPLtCAULETO CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: