HomeMy WebLinkAboutE2019-0677 - Permitst City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Electrical Permit: E2019-0677
w ' Permit Counter Phone (949)644-3288
Project No : 2230-2018
Inspection Requests Phone (949)644-3255
Job Address: 16 VIA AM13RA Bldg. 1 Floor: Suite:
Description of Work: ELEC FIXTURES AND OUTLETS THROUGHOUT
(X2019-2038 8, X2018-2792)
Inspector Area. 8
Code Edit: 2016 ' 1 �9 S Er�^T- T n
Legal Description:
1
°
..
Owner: MASOUD BOKAIE Contractor:
Address: 18VIA AMBRA
DAS CONSTUCTION
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Address:
NEWPORT COAST CA 92657
120NEWSTUCTI CENTER
Worker's Compensation Insurance •_••
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Phone: 949-302-8092 Phone:
NEWPORT BEACH CA 92660
Carrier: STATE FUND
Policy No: 9217161 • `
Con StateLic:
Issued Date:10/04/2019
949-836-0931
708642
° @®®
Expire:08/31/2020 m6<c °•°„ o
tic Expire:
11/30/2019
Bus Lic:
Processed By:
Lic Exp Date:
BT30053983
° • ° ° °'°
04/30/2020
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0 $0.00
0 $0.00
0-600V up to 20OA: 0 $0.00
0-600V over 20OA: 0 $0.00
Over600V or1000A: 0 $0.00
O/H to U/G 0 $0.00
Receptacle/Switch/Outlets
Receptacles/Outlets:
3
$3.00
Fixtures:
3
$3.00
Sep Circuits:
1
$7.00
Low Voltage
4
$4.00
Signs
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee :
$0.00
FEES
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
Temp Underground:
Sub Panel:
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
"" "'"'"" Fee Due at Permit Issuance : $
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.
0 $0.00
0 $0.00
0 $0.00
0 $0.00
$0.00
$0.00
$0.00
$35.00
$0.00
NER-BUILDER DECLARATION its
count that requires a permit to construct, alter, improve, demolish, or repair commenny ture, ff
lion issuance,
, also
vie on ir of the Buslicant for
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 checkmarkave placed next to the applicable item s
cing
ith
ness and
ter
;lion 7031.5, Business and Professions Code: Any city or Y
permit to file signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chap
'essions 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 fomit subjects the applicant to a civil penalty of
more than five hundred dollars ($500). all of or portions of the work, and the structure is nnded or offered for sale (Section 7044,
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) (_)
he
Iness and Professions
intended Code: The
or offered for sale. State
License
,thew do ng otia impy to an rovement snsolder fwithin o e year of complet oerty who, through lnYthe Owner -Builder e burden of provings or improves the t that itwasnot built d that torr
rove
roved for the purpose of sale). S is Codei The
Ily to an o1y$arfofp1, as owner Of the Poperty wam ho builds exclusively
thereon, and who contracts for the projects with a licensed Contractor pursuant to he Contractors' License rLaw)s- State License Law does not
1 am exempt from'liceneure under the Contractors' State License Law for the following reason: of the ale law, Section 7044 of the Business and
rznyignatu� fromIacknowledge thatexceptesidence in which I must have resided for at least one year prior to completion of theements covered by this permit, I cannot legal)
astructuretMdtt have builtasaowner-builder if it has not been constructedinseyontractors. I understand that a copy DateSBons Code, is available upon requeswheniWb site:http://www.leginfo.ca.gov/calaw.html.�ii9ture ofPrGper6NOwner orAuthorizd Agentlicense�Et'rED �(7sd,Td2ACTOR'S DECLARATION ^ _ fe I affirrci,�ry(lEr penalty of perjurythatIamldrovisions of Chapter 9 (commencing with Se lion 00 ) of Division 3 of the Business afes ons C dact.Contractor Signatu
yer59 Class
• • • • License No
pFJL)THE
ERS' COMP€NSATION DECLARATION
ST IOF COMPENSATOION,T)A S TOSESURE I AS PROVCOMPENSATION
IDED FOR IN SECTION IOF THErLABOR CODE, ANTERESTEAND ATTORNEYS FEES.
RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS iS'IOD,aODi, IN ADDITION TO
ereg;affirm v0dej penalty of perjury one of the following declarations:
Ill.•R f•.
have and wi1T 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
,rff mance 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
s ance earllier and policy number are' Expiration Date
arse li / Policy Number Phone #
ame of Agentany manner so as to �Itc frtishouad becomes ub a Cethf tworNerk for whl osafioo proviis ons of Sect on113700eofnhe Labor Code,l hall forthwith b mplybwith hose provis of s. workers �� sation laws of California, and agree
i
Date `�
ignature of Applicant
iECLARATION REGARDI CONSTRU TION LE DING AGENCY
hereby affirm under pena y of perjury that there is a construction lending agency fo Lender's Address of the work for which this permit is issued (Section 3097, Civil Code).
ender' Name
iy de signature below, I certify to each of the following �(1J 7L�+i'tJ liC�"
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 aw relating to building construction.f(( Datgr ��
I authorize representatives of this city or county to ed r e �ovd idsrljifi perty for inspection nt Property Owner's Authorized Agent's Name A
ACTION DATE /4B"yFEDERL REGULATIONS PART#70F 1t/LtavEuvutAQMD RULE 1403.KPIRED ❑ ISIIBMITTEDASBESTOSNOTIFICATIONTO:❑ EPA'ANCEttED ❑ AQMD
XTEND€D ❑ ASBESTOS NOTIFICATIONIS NOT APPLICABLE TO
=1NAt '—j—%-Zb PROPOSEDDEMOUTIOM
ATE OF SIGNATURE:
OCCUPANCYISSUEO