HomeMy WebLinkAboutE2022-0291 - Permits0I City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Electrical Permit: E2022-0291
.� �+ 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 2 0 2 9 1 Project NO : 2126-2020
v Permit Counter Phone (949)644-3288
t'�arae>v i� i as p E-C d Inspection Requests Phone (949)644-3255
Job Address: 2286 CHANNEL RD Bldg: 1 Floor: Suite:
Description of Work: ELEC TEMP POWER POLE
Inspector Area: 7 �j Code Edit:
Legal Description: TR 514,LO A3L.i'z P ei i ir�r o � _ 'T '"� plicable:° .°
Owner: VITO ANTOCI tra GE�Y�gW L� II LDRSiNC r r 10
% refund
`tiVorke s Compensation nsuYdnce
Address: 124 S CLIFFW�D /AYE„ A re$� f�7 y Sd A LDOsST'5' Carrier : STATE FUw • a
LOS ANGELES A 9 049 �„1„ a , E RT., EACH CA'Poli v Nn a0aa+n6
Phone: Pkfor# A 4 gg0 �C whom'. ir m °
5 � Expire : 08/15/2022 �
moo ' S'em
L Con State Lic 971085 tl
Issued Date:05/09/2022 ,,. LicWir� �-,�(3*1/pg p,� r p r °••° roo..
`BUS L-gPI � BT30MU0- 67- ciJ12Processed By: ra L Exp,; �te�;s-03* 2� -i 0°'a e • °
`a .. � a.m Gaavlm0
a a Omma
New Construction
Residential
1
a
�^„n 9
ReceptapieefS h10Ukdet '
vz.�,``R-E pt�C'les/Outlets Jh a 0.00
�"' ' r'a �. yew,., sa i s 3 ? .,
aMota�s/YranSln_oFrAOr�sR(.HPdKv'"
:NHP%KtN/KVrX b $0 00 Temp U der&pund:
0
@
- $0.00
Multi -Family
0
$ 60
Fixtures 0 $0.00
/ 1
1 to 10 HP/KW/F��FA, 0--$I�(10
!a o.'i c�—F6...
Sub Pariel. t:,
0
$0.00
1-2 Family:
:,'0
$0.00
t1b'ep'C duft'. °=ii`-;1 0 $0.00
10 to 50 HPhCW/KVA: 0 $0.00
I
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:
d llgmt Fee:
$0.00
0-600V up to 200A:
0 L$"10`-
--Bra
' .
Plan Ch k Fee:
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit: 0 $0.00
Piggy Backrremp Powers '"0 a0.41b'W a
iga_on,Fee:
$0.00
Over 600V or 1000A:
: 0 r
-$0 00
Time Flocks.
--Temp Power -Po - I—eI $42 00;, .
Jssuaa� Fee:'
$38.00
O/H to U/G
0
Supplemental Fee:
$0.00
TOTAL
Fee:
$79.00
Plan Check Fee : $0.00
Fee Due at Permit Issuance :
$79.00
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
OWNER -BUILDER DECLARATION I
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
the 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
not more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The C ntrartors'State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor ur - -- Ice a LaW).
I am exempt fryplljcensure under the Contractors' State License Law fol„theS II � �=_�`"-""`c`�
:;d
By my signature below I acknov
sell a structure that 1 Rave built
P1&9s%T1cMs Cod{,'i$ aEailable t
Sigpatge of Property-6wner or
LICENSED CONTRACTOR
I hereby affirm undefpenalty of
awd effec4. �....�
Lltens2'Class�
dRMS' COW..FASATI
ARAIT& FAILURE TO$ECURE WOR
owner -builder if
aereby affirm uoderpAgalty of perjury_-
: 1`ifMJ and wit maljrgain a crtifiC9'
a xrenceofthewerk.orwhicl€thiso
r
and will maintain worke' tort
5urance carrier and policy numb, r are:
hich I must have resided for at least one year prior tolcompletion of tl
in fITMntirety by licensed contractor I fit e,7$# chat=e copy of the
FORT... COVERAGE IS UNLAWFUL, AND SHALL SUBJECT - EMPLOYER TO CRIMINAL
FOR IN SECTION 3706 OF THE LABOR CODE, INTERESTht?NOATTORNEY'fiFEE$",`;'`3,
to
as required by Section 3700 of the Labor Code, for the
Policy Number
me of Agent 2 I certify that, in the pe ante Gf e for whlct� t}lis pertnit Is;issued I sMaFt riofJemploy any person Ir
it, if 1 should becom b the a ation provisions, of Section 3700 of the Labor Code, I
of Applicant
reby affirm under penalty-b perjklry that there is a construction lending
Ider's Name \\ - --
my signature below, I certify Neach ofihe following:
I am the property owner or andrized to act on the owner.'
I have read this application and the -inform on a pprovi d is rr
I agree to comply with all applicablecityand-od an sl
I authorize representatives of this city or count t ter the bov
nature of Property Owner or Authorized Agent
for the
of Division 3 of the Business an
r
'" 0!'g Ign ure ,1,
U-T ES AND CIVIL FINES UP TO ONE HUNOR - THO
of Industrial Relations as provided for by
oertormance of the work for which this pe
tr'F�t�tratlotri dad"._,
�r s'. as tp beys p0ailbject to the worker `I
ith- oinply With tiiosepprov' ions
D
C is Dermit is issued (Section 30IV
rs relating to building construction.
property for inspection purposes.
Print Property Owner's or Authorized Agent's NameyAr
and
and my license is in full force
ADDITION TO THE I
of the Labor Code, for
is :i69ped. My workers'
laws of California, and
AC77ON
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 51 OF TITLE40 AND
AO -I.- 1403.
PERMITEXPIRED
l
❑ I SUBA fTTEDASBESTOS N0T7FICATION TO:.
❑ EPA
❑ AOMD
PERM1TCANCELLED
PERMITEXTENDED
ASBESTOS NOTIFICATIONISNOTAPPLICABLETO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIFICATEOF
SIGNATURE:.
OCCUPANCYISSUED