HomeMy WebLinkAboutE2022-0036 - PermitsCity of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2022-0036
Project No : 0265-2021
Inspection Requests Phone (949)644-3255
Job Address: 2301 15TH ST Bldg: 1 Floor: Suite:
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Description of Work: ELEC/INSTALL (2) A/C UNITS (H2O22-0038)
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Inspector Area: 3
Code Edit: 2019
Legal Description: FIRST ADD TO NEWPORT HEIGHTS BLK 38 LOT 13
Owner: HATZIRIS VASILI Contractor: OWNER/BLDR
Worker's Compensation Insurance
Address: 2301 15TH ST Address: HATZIRIS VASILI
Carrier:
R'
NEWPORT BEACH, CA
Policy No:
Phone: 310-456-4493 Phone:
Expire:
Con State Lic: O/B
Issued Date:01/24/2022 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
v
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 over 20OA:
0
$0.00
Over600V or1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL Fee:
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Fixtures:
0
$0.00
Sep Circuits:
2
$14.00
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
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 Backrfemp 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 : $52.00
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.
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)
iection 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
ie 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
'rofessions 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).
1, 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
Kenn
ents 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 d for the purpose of sale).
I, 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
ppl o 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:
y 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 legall7
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 whe �pplicati n is sugml ad or at the following Web site:http:t/w .leginfo.ca.gov/calaw.html.
ignature of Property Owner or Authorized Agent \T Dat' I
.ICENSED CONTRACTOR'S DECLARATION
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
nd effect.
icense Class License No Date Contractor Signature
✓ORKERS' COMPENSATION DECLARATION
'ARNING: 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
OST 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:
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
erfonnance of the work for which this permit is issued. Policy No.
11 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' compensatioi
Isurance carrier and policy number are:
Policy Number
of Agent
Date
certify that, in the performance of the work forwhich this permit 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
Sif I should become subject to the
pworkers' c�omipensation�provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant X \ Date/��/2 Z
CLARATION REGA2dMIG CONSTRUCTION LE NG 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).
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 count to ter the above=d n led prop o�r spection purposes. _ h / I
nature of Property Owner or Authorized Agent �"'�i I I \] rint Property Owner's or Authorized Agent's Nam ei.( V �`Sr Dat //2Y�
ACTION
DATE
BY 0
COMPUANCE KITH CODE OF
DECLA3��\r,4
FOR OFFICE USE ONLY
rEDEP-T)ONS PART 61 OF TITLE 40 AND
AQMC f
PERMIT EXPIRED
',] Is ITASE-ST9S NOT/FlCATfON TO:
❑PERMITEXTENDED ASOTIFICA DON IS NOT APPLICABLE TO
10DO11TION.
PERMITCANCELLED
PERMIT FINAL
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