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Home My WebLink AboutE2019-0507 - Permitsn City of Newport Beach - Building DivisionIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII II Electrical Permit: E2019-0507 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 5 0 Project No Permit Counter Phone (949)644-3288 nsp `c%n '`equests Phone (949)644-3255 If applicable: job of Work: ddress: 16 S) BILE MOB LEC CHAN EBOUTI Floor: U Suite: Description ( S (2) u Ts d ULL cI (CARt f 4leBBst�1>Q }und Inspector Area: 6 to whom: Gede Edit! 2016 Legal Description: 66J Owner: ONEIL INQ•RID Xtra Worker's Compens ion Insurance Address: 16 SABLE?AN f2311 DERAS Carrier: LIBER MUTUAL NEWPOR ' BEA 57 CA 92688 Policy No: WC2 61036218098 c Phone: Phone: 949-589-2021 Expire : 07/0112120 el Con State Lic: 526420 Issued Date:07125/2019 LI Epi : 03/31/2020 I a n a ?�us i pig �BT3001923Discard r� Processed By: Lc a 02/26/2020 999___ (work started) (no work starters) New Construction Receptacle/Switch/Outlets Motors/TransfQ,r�rr �ere ( 1 yp z ' �g Residential Race tacles �t3. i 1 : 86 . T p.; derground: 0 $0.00 Multi -Family: $0.00 Fixtures: °" "" Pal: 1 $26.00 1-2 Family: ep 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 Backfremp 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: $35.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 TOTAL Fee: $61.00 Plan Check Fee : $0.00 Fee Due 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. 4 m4 6 iL e c e me o c ccc c ccc c •4 c e. c c c4 �c o 464 4® X44 4 6 G6. 66 1WNER-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 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, lusiness 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 Aroved 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 poly 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). 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 legall) 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'taw, 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.html. 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 Sectiory7000�.D�sion 3 of the Business and Pr essions C de, and my license is in full force ��,¢ is effect. y L ? Contractor Si icense Class License No Dat(Ir"`+ gnatur IIORKERS' 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 ($700,0 I, IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 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 th Irformance of the work for which this permit is issued. Policy No. 01 have and WI 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' compensatiol Isurance carr gd policy numbe are: arrier . & Number Expiration Date lame of Agear, Phone # ]I certify that, in the performance of the work for whichi4bis permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation s of California, and agre iat, if I should becom subject to orkers' compen tion provision of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. o, ignature of Applican Dal �` f iECLARATION REGARDING C STRUCTION LEri6y4G AGENCY hereby affirm under penalty of perjury that there is Vnstruction len ing 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 owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinan s and st laws relating to building construction. leiS I authorize representatives of this city or county t_ opnter a above-ide ifi d property for inspection purposes. C/� / innatllrw of Prnnerty Owner nr Authnrized ADent 0 �LL� ,.- ate' Print ProDertv Owner's or Authorized ADent's Name T� CQ,/C �J iii l% Da e AC77ON DATE I BY I met roar riser air wVOWVUrIVUC verrn a..vueVr FE LWHEGNbATIONSPART4?OFTIZE40AND XPIREDAQMDRj/4-E7403. ; - r' (o —1 -S--Z 1 I h�, Imo— ),-- 1 ❑ t SIVAOTTeQASDE3i!O$ N47WICA'lfOly TOr RNAL OCCUPANCYISSUEO U EPA • ••• ••• ❑ AQMD ❑ ASBESTOS 11107711CATIONIS NOT APPLICABLE TO PROPOSESOEA 7TINN • •.• SIGNATURC. i 0: i i r• • 0