HomeMy WebLinkAboutE2022-0068 - Permitsi, City of Newport Beach - Building Division
o� 100 Civic Center Drive, Newport Beach, CA 92660
' > Permit Counter Phone (949)644-3288
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Electrical Permit: E2022-0068
Project No: 0285-2022
Inspection Requests Phone (949)644-3255
Job Address: 2223 LAUREL PL Bldg: 1 Floor: Suite:
Description of Work: ELEC TO BBQ 4E>
Inspector Area: 3 C2+�' ode Edit:20
Legal Description: TR 1188 LOT 1 ALL -EX SELY 4 FT- rj 1 ko
Owner: GALLOWAY WINN & LINDYE Contractor: IHP ERPRISES I qCu .�� Worker's Compensation I ureft&
Address: 2223 LAUREL PL Address: 2 2 ARCA�IAN AV/ Carrier: ACCREDITED RLq
NEWPORT BEACH, CA ISSION W60 CA 92691 `T� Policy No: 0722;Q21
Phone: 949.887-3183 Phone: 949-98 722 �� Expire : 071
Con Stat c: 103 78
Issued Date:02/03/2022 Lic E ' e: 30/20'
Bu ic: 1373 2t
Processed By: c Exp Dat 03/ /202T� R. k.0C
r•''
New Construction
Residential
Multi -Family: 0 $0.04
1-2 Family: 0•�� $0
Service
%
0-600V up to 20OA:
0
$61ko
0-600V over 20OA:
0
$0.010
Over600V or1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL
Fee:
$41.50
�p /Sv t.'f.Cf tlets ,.'� rslTransf er
Iles/ ts: 2 to 1 HP/K VA:
0 1 to 10 HP/K K 0
Ci 0 10 to 50 HP/K VA: 0
Voltage ti 0 50 to 100 HP/KW/KVA: 0
0y00 HP/KW/KVA: 0
Circui . , $0.00
-;'.
i ircui : $0.00 _p ',�,Qgy Back/Temp P er:
I 0 $0.00 1 Temp Power Pol ^p-
a o + 4t.
.PER JTS -`IRE 18YS
Construction Hours: Mortday - Friday 7:0
Fee: /$0.00
$0.00 A,-Teuncfi
$0. ��+.�' �s"�_ Panel:
a
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
Fee Due
ISSU4XC§o6P LAST VALID INSPECTION
to 640,0N. and Saturday from 8:00 a.m. to 6:00 p.m.
0 $0.00
0 $0.00
0 $0.00
0 $0.00
$0.00
$0.00
$0.00
$38.00
$0.00
ER -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)
(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 Iicensure 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 ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of Nle- rk, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thr � empleas' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one ye completion, Ike Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale). ,.
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the proje,�(Section 7044,
y to an owner of property who builds or improves thereon, and who contracts for the projects with,Wcensed Contractor
LJ I am exempt from Iicensure under the Contractors' State License Law for the following
By my signature below I acknowledge that, except for my personal residence in which I mL
sell a structure that I have built as an owner -builder if it has not been constructed in its en
Professions Code, is available upon request when this application is submitted or at t o
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provision Chapter 9 (c
and effect.
License Class License No
VORKERS' COMPENSATION DECLARATION
EARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVE IS UNLA
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECT 3706 OF THE
hereby affirm under penalty of perjury one of the wing declar ons
I have and will maintain a certificate onsent to se nsure for w7o''rkers'
ep- rmance of the work for which this p is is icy No. ?"
Gu h e and will maintain worker am ens - surance•, as required by'$
Suran a carrier and policy nu rare: ��.
:a er P'olicy Numb-qr
lame of Agent A'�'-.�a:
certify that, i e pert mence of the work for which this permit is ISSUE
if I should be me stject too/ the workers compensation provisions of
lature of Applica
Ri
areby affirm under penalty of perjury that there is a•6onstruction_land7fig agency for
Ider's Name
my signature below, 1 ce\appl
I am the property owner
I have read this applicat
I agree to comply with a
I authorize representatives of th
of the following:
zgd�-to act on the property owner's
e'�nformatlon I have provided is co
le city and county ordinances and
city or county to enter the abqyfik-tt
by
Professions Code: The Contractors' State License Law does not
to Contractors' State License Law).
mmeOn llaith Sectio 0) of Division 3 of the BusinesNHUNDR
Dgqate Li> �� Contractor Signatu
T AN E PDOOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TQ,QRNEY'S FEES
3tlon sued by the Director of IndustvI la provided for
D of the Labor Code, for the pe�il0a of \ work for whic is
employ any pe m Oman as to
of the Lab od shall,fprt�l In comply
0
ormance of the work for
Address
law, Section 7044 of the Business and
Date
Code, and my license is in full force
DOLLARS ($100,000), IN ADDITION TO THE
of the Labor Code, for
My workers'
compensation laws of California, and
(Section 3097, Civil Code).
or Authorized Agent's Name 1 hW51W
ACT(ON
D
8:)<a
-.
CLARAT N OMPLIART 61OF CODE
- FEDE CATIONS PARTfii OF TIRE 40A190
AQ., f403.
" f M1TTED A_'"BESTCS ND77rlC4TIOk T(�:
EPA
❑ AQMD
❑ ASBESTOS NORFICARON IS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
S(GNATURE.•
FOR OFFICE USE ONLY
PERMITEXPIRED
�� -Z
r
PERMIT CANCELLED
PERMi TEXTENDED
t
PERMIT FINAL
'•i"'
CERTIFICATEOF
OCCUPANCY(SSUED
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