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HomeMy WebLinkAboutE2021-0195 - PermitsCity of Newport Beach - Building Division p. 100 Civic Center Drive, Newport Beach, CA 92660 h. Permit Counter Phone (949)644-3288 Job Address: 3706 CHANNEL PL Bldg: 1 Floor: Suite: Description of Work: ELEC INSTALL SUBPANEL Inspector Area: 1 Legal Description: CANAL SECTION LOT 4 BLK 637 ALL -INC BET SAME B HIGH TIDE LINE - Owner: LEIFER LAURENCE Contractor: Address: 3706 CHANNEL PL Address: NEWPORT BEACH, CA 92663 Phone: 949-290-2627 Phone: Con State Lie: Issued Date:03/1 /2 1 Lie Expire: Bus Lie: Processed By: Lie Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $65.00 *E2021-0195* Electrical Permit: E2021-0195 Project No: 1057-2020 Inspection Requests Phone (949)644-3255 Code Edit:2019 INSPEC OWNER/BLDR Worker's Compensation Insurance Carrier : Policy No: Expire Ole Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 Plan 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 Q • YQQe Q• i • • Y 4Y SQ Q Q Q Q 0 WQ• p Y oaa � aaac• i• e O 3 �Y 0 3 Temp Underground: 0 3 3 �8.903• Sub Panel: .....1 $28�19•Y 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 Fee Due at Permit 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. 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) 1 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 m 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 �'rof ions 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 Sowneriof hundred dollars ($500). 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, slness 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 nprove nts 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 npro the purpose of sale). I, as own r 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 p y 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 Iicensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for mJ personal residence in which I must have resided for at least one year prior to completion of the improvemen;Sec red by this permit, I cannot Iegall) ell a structure that I have built as an owner -builder if it s not been constru led Its,entirety by licensed contractors. I understand that a copy of the applicable law,n 7044 ofth Business and 'rofessions Code, is available upon request en ation is subm tte or t th_ryl��,Ilowing Web site:http://www.leginfo.ca.gov/calaw.html.signature of Property Owner or Authorized Age �'Al� .ICENSED CONTRACTOR'S DECLARA hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force Ind effect • .icense Class • License No Date Contractor Signature VORJ(RS' CpNjPEVSATION DECLARATION IARNING: FAILUREMO SEdURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE :(1$jOFFWMPENSAT19N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. fiere0f affirm under penalty of perjury one of the following declarations: 211•have and will mailrtain 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 performance of the work for which this permit is issued. Policy No. '" 6 . �gvfand wIm m4liltain 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 Carrier arrd policy number are: • • • Policy Number Expiration Date • • Phone # `BeruTy that, iM 6 peifor ance of the work for hic this permit is issued, I shall not employ any person in any manner so as to become subject to t re workers' compensation laws of California, and agre t, if I should ecome subj ct/tJo the workers' co pen ation visions of Section 3700 of the Labor Code, I shall forthwith comply with those pro ' i S. ILI nature of Appli {7ZLf.n r-� 1 Date CLARATIO ARDING CONSTRUCTION LENDING AC&NCY !reby affirm under 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.Pave provided is correct. I agree to comply with all applicable city and co ty ordinances a s to la relating to building construction. I authorize representatives of this city o ou t ter the ab a id tifie perty for inspection purposes. r nature of Property Owner or Authorized A ttA Print Property Owner's or Authorized Agent's Nam � q� �. 4Dat js ACORN DATE BY DECLARATION OF COMPL/ANC€W/TH CODE OF FOROFRCEUSEONLY FEDEP4LREGU€ATIONSPART61OFTIR€40AND - AQMD RULE 1403. PERMITEXPIRED ❑ I SUBNTTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMiTD(T€NDED ❑ ASBESTOS NO17RCAiiON IS NOT APPLICABLE TO PROPOSEDD€MOEfT1011. PERMIT FINAL V Z d CERTIFICATEOF SIGNATURE OCCUPANCYISSUED