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Home My WebLink AboutE2021-0170 - PermitsQ# City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ' Permit Counter Phone (949)644-3288 u- rrc�,u�° IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII0111111111111111111111111 Electrical Permit: E2021-0170 Project No : Job Address: 3 RUE BIARRITZ Bldg: 1 Floor: Suite: Description of Work: ELEC -R/R WIRING @ 3 CIRCUITS DUE TO FIRE DAMAGE INCLUDES BONDING Inspector Area: Legal Description: N TR 7809 LOT 25 Owner: RUSSELL CAROLYN Contractor: Address: 3 RUE BIARRITZ Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lie: Issued Date:03/05/2021 Lie Expire: r� Bus Lie: Processed By: (l l / V \ . Lie Exp Date: PETERKIN ELECTRIC 216 N WAVERLY ORANGE CA 92866 714-915-1412 618717 05/31/2031 BT30074519 03/31/2022 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 3 $21.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20DA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Inspection Requests Phone (949)644-3255 ' �fff i vd Code Edit:2019 ••.• m e • a•eeo� •• e m e o • Worker's Compensation Insurance e Carrier: EXEMPT :•••:• m Policy No: •••e mmmm Expire: m °0000 e•eoo 0 me•mno e♦ m m e e .. m mmoa �, m m ommmmm mmo� m 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 Backrremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Fee : Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $37.00 Supplemental Fee: $0.00 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. 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 items) ction 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' Stale 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 `) portions of the work, and the structure is not intended or offered for sale (Section 7044, ;iness 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 purpose of sale). I, 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 ,ly to an owner of"@perty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am P•xempt frEmMicensure under the Contractors' State License Law for the following reason: mysirature below &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 a structure th!1iUr 8 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 fessrops Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm.l. natem of Property Owner or Authorized Agent Date LENSED I:6&RA&TOR'S DECLARATION Irebyaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business anp Professions e Ird my lice full force .... Deis &qsg Ctlass • • • • • • License No Date 3— 1 0 " Z Contractor SignatureY/ ;lIdKJERS' COMPENSATION DECLARATION udMG: i,•AILURE 16 S%CIJ(l E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE IT OF COMPENS, 4,13 AGES AS PROVIDED FOR IN SECTION 37DS OF THE LABOR CODE, INTEREST, AND ATTORNEY '8 FEES. ....• .reby affirm under per$alty of perjury one of the following declarations: I have and will mairRain 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 tht formance of the work for which this permit is issued. Policy No. 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' compensatioi trance carrier and policy number are: Policy Number Date la a of Agent ' """ n I certify that, in the performance of the work for whi this permit is issued, I all not employ any person in any manner so as to become subject tot workers' compensation laws of California, and ogre 1 If I should became u ject to the workers' c as' provisions e n 3 of the Labor Code, I shall forthwith comply with those provis' 2 !� 'signature of Applicant Date J / v Z IECLARATION REGA ING ONSTRU ION LENDING AGENCY hereby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sect! n 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 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 c u y ordinances and to laws relating t ng construction. I authorize representatives of this city or coun t enter the abo ' e e pection purposes. signature of Property Owner or Authorizf rint Property Owner's or Authorized Agent's Name �edc O rc�/zf'-rC r,Date / /t ACTION 1 DATE I BY 61 OF T/TLE40 AND ❑ I SUBMiTTEDASBESTOS NOTLFICATIONTO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. FOR OCCUPANCYISSUED I 1 11 5iGNATURE