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HomeMy WebLinkAboutE2021-0551 - Permits¢ano City of Newport Beach - Building Division IIIIIIIIII'IIIIIIIIIII�I'IIIIIIIIIII II Electrical Permit: E2021-0551 a d 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 5 5 1 Project No �.; � Permit Counter Phone (949)644-3288 is rr+�.q��' Inspection Requests Phone (949)644-3255 Job Address: 107 25TH ST Bldg: 1 Floor: Suite: Description of Work: ELEC-OVERHEAD TO UNDERGROUND. Inspector Area: 1 Code Edit: 2019 Legal Description: NEWPORT BEACH CITY ELK 25 LOT 32 Owner: WETZEL ROBERT EMIL Contractor: CONTORELLI CONSTRUCTION INC Worker's Compensation Insurance Address: 107 25 ST Address: 17686 METZLER LANE Carrier: STATE FUND NEWPORT BEACH CA 92663 HUNTINGTON BEACH CA 92647 Policy No: 9154910 Phone: Phone: 949-290-4630 Expire:03/15/2022 Con State Lic: 319552 Issued Date:09/03/2021 Lic Expire: 08/31/2022 Processed Bus Lic: BT30065552 , By: Lic Exp Date: 0113112022 s 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: 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 1 $47.00 Additional Fee : $0.00 TOTAL Fee: 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: 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 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. INER-BUILDER DECLARATION 1 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) 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' 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 for a permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). j J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu mprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of CI mproved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7C apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra ❑ I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least o sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.k Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7PO and effect. License Class License No Date COMPENSATION DECLARATION FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL 'rj1MPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. penalty of perjury one of the following declarations: eve and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Direc 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 I trance carrier and policy number are: Tier Policy Number ne of Agent certify that, in the performance of the work for which this ermit is issued, I shall not employ any person in any me I, if I should become subject to the workers' co satiopprovisions of Section 3700 of the Labor Code, I shall foi nature of Applicant L�- CLARATION REGARDING CONSTRUCTION LEK G AGENCY !reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for 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 correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or coun er t ove-identified property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the Dilation, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year prior to completion of the improvements covered by this permit, I cannot understand that a copy of the applicable law, Section 7044 of the Business and linfo.ca.gov/calaw,html. Date Division 3 of the Business and Professions Code, and my license is in full force Contractor Signature �` AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION To THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date so as to become subject to the workers' compensation laws of California, and agre h comply with those provisions. 21I Date / this permit is issued (Section 3097, Civil Code). INA ACTION DATE BY DECLARATION OF COMPLIANCE WTN CODE OF FOR OFFICE USE ONLY FFj}ERgL REGU4ATIOAISPART 61 OF TITLE40AND AQMD#?t# E 14n PERMIFEXP{RED • . GI •I SUBMI3TED ASBESTOS NO nFICATION TO: . •❑. • .EPA • ❑ AQMD' PERMIT CANCELLED • , • • , PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO ,PRQPOSEO& AOLI-NON. . BIGNATIIA..E'• . PERNRTFINAL •:• CERTIFICATEOF OCCUPANCY1550ED . . • ° � � , ° •