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HomeMy WebLinkAboutE2021-0473 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 365 SANTA ISABEL AVE Bldg: 1 Floor: Suite: Description of Work: ELEC/UPGRADE (E) SERVICE PANEL Inspector Area: 3 Legal Description: TR 300 LOT 105 POR.OF LOT Owner: MATKOV MATTHEW/CAROLYN Contractor: Address: 365 SANTA ISABEL AVE Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:08/09/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: Il�El0ll0�l 4lll��73 II HIGH ELECTRICAL PERFORMANCE 105 COMMON AVENUE LA PUENTE CA 917" 213-361-3074 737833 07/31/2023 BT30076210 08/31/2022 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: 0 $0.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 1 $47.00 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 Fee: Electrical Permit: E2021-0473 Project No : Inspection Requests Phone (949)644-3255 cc Code Edit: 2019 Worker's Compensation Insurance Carrier: NO EMPLOYEES UJ Policy No: 0— Expire : 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 Plan Check Fee: LI 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: $38.00 Supplemental Fee: $0.00 Fee Due at Permit PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Fridoy.7.QQ a.m. tq, $:3Qp.m. and Saturday from 8:00 a.m. to 6:00 p.m. B•. • O 4 • 6 0 • fl d O- a • 3 +`J ei5 s• ••G �4 •G O - O• Y oOB ONB t 9 •O� YO 0B• IWNER-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 le 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness 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 nproved 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 pply 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). 7 1 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 legally 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 law, Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:/Iw .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 Section 7000) f Division 3 of the Business anc(Pro ion ode, and m� license is in full force nd effect. !l-/l �jl� icense Class ' License No� Da G Contractor Signatur VORKERS' COMPENSATION DECLARATION IARNING: 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 ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th erformance of the work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' rance carrier and policy number are: ler Policy Number Expiration Date Agent certify that, in the performance of the work for which this er It is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre ij should become ubject t0 1 wo rs' compensation pt 'ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio0s. j f/ l nature of Applies t 's' —J� Date X 1���� C' I 1L.� CLARATION R A ING CONSTRUCTION LENDING GENCY !reby affirm un r penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is porrect. I agree to comply with all applicable city and counordantes d state laws r ling to building construction. I authorize representatives of this city or courl(y tint th ° ab v -identified p rty for inspection purposes.\Cly,/1.,r1 nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam AC77ON DATE BY DECLARATION OF COMPLIANCE MTN CODE OF FOR OFFICE USE ONLY fEj7E$AL R,9r41L2kTjpNSPAITT E$DF TITLE40AND AQMDRULE 1403. • - PERMITEXPIRED t] • i SUBMTTItL AS°BESTOS:NGAFICATION' TO: t] EPA ❑ AQMD PERMITCANCELLED PERA41TEXTENDED ASBESTOS NO nFICATION IS NOT APPLICABLE TO (ASFJJ pElptO${iipbE` : `. o s • • + e SlcraATiaE. PERMIT F1NAf .Z C64TIFIC4TEOF OCCUPANCYISSUED