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Home My WebLink AboutE2019-0156 - PermitsCity of Newport Beach - Building Division 11IIIIIIIIIIIIIIIIIIIIIIJill IIIlIIIIIIIIIIIIIIIIIII 11 Electrical Permit: E2019-0156 100 Civic. Center Drive, Newport Beach, CA 92660 E . 2 0 1 9 : - 0 1: 5 6 Project No : 2632-2017 .k, Permit Counter Phone (949)644 3288 rin. �s Inspection Requests Phone (949)644-3255 Job Address: 2807 CAROB ST Bldg: 1 Floor: Suite: Description of Work: ; ELEC PANEL UPGRADE 200 AMPS*CHANGE OF CONTRACTOR* Inspector Area: 8 Code Edit:2018 I Legal Description: N TR 4892 LOT 30 c Owner: HOWELL CHUCK & MARTHA Contractor: COUSENS CONSTRUCTION INC Worker's Compensation Insurance Address: 2807 CAROB ST Address: 6100 SAN FERNANDO RD #201 Carrier • STATE COMP INS FUND f, NEWPORT-BEACH, CA 92660 GLENDALE CA 91201 Policy No: 1251698 c Phone: Phone:' 818-236-3999 Expire:09/0112019 Con State Lic: 535683 Issued Date:03/15/2019 Lic Expire: 11/30/2020 Bus Lic: BT20052603 ,/� Processed By: 5Yl V ' C Lic Ezp Date: 05/3112019 FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 ` Temp Underground: 0 $0.001 `Multi Family: 0 $0.00 Fixtures: 0- $0.00 ` 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $01.001 1-2 Family:'` "0 $0.00 Sep 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: $0.001 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00I Over 600V or 1000A: - 0 $0.00: Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $0.00, O/H to U/G 0 $0.00 Additional Fee: $35.00 Supplemental Fee: $0.00 TOTAL Fee :$35.00 Plan Check Fee: c $0.00 Fee Due at Permit Issuance : $35.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION - Construction Hours: NJonday - Friday 7:00 a.m. to 6:30p.m. and Saturday from 8:00 a.m. to 6:00 p.m. C • f O Oi O O':O 0: Op0 6 Oc0 Od ®.: Y OCO O ....ODD PO. INER-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) action 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' State 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 fora permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U 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 uovements 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 fly 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). I am exempt from licensure under the Contractors' State License Law for the following reason: 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 legal) 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 fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Property Owner or Authorized Agent Date TENSED CONTRACTOR'S DECLARATION ireby 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 rofessions da,`nd my license is in full force I effect. - anse Class License No Dat Contractor Signature )RKERS' COMPENSATION DECLARATION tNING: 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 IT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - irebyaffirm 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 tormance of the work for which this permit is issued. Policy No. have and �pill�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'' compensatio trance car ridt Slid, policy number: Expiration Date certify that, in the performs the work for which this permit is issuedI shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre hg if I should become su ect to twer �1Y58 raR-sreuisions of Section 3700 of the Labor Code, I shall forthwith comply with those -provisions. - tature of Applicant :LARATION REGADIN61CONSTRUCTION LENDING AGENCY 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). der's Name Lender's Address ny 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. 1 agree to comply with all applicable city and county ordinances and state laws relating to building construction... I authorize representatives of this city or count n art re Pnrfied nrnnertY_for inspection purposes. �S�[ tature of Prooertv Owner or Authorized AGentt r7 �� 'nt Property Owner's or Authorized Agent's NIS 10/ / AC770M DATE BY UCLLAKA rrUN Ur LVMFGARLC M r n LVVC ur run vrrl .Uac UM FEDERAL REG fIAVVy5PAPT11dJFTITLE40AMID XPIRFD AQMDRULE ❑ ISUB f7tE4AS23ES.o.§rronrvTgov.To.; ANCELLED ❑ EPA. * i 0 ' • • : i • ... XTENDED ❑ AQMD ❑ ASBESTOS NOlIFICARONIS NOT APPLICABLE TO 1NAL Q. PROPOSED DEMPLIWAR • •. •+• ITE OF V• UCYISSUED SIGNATURE: - � • • . • •